| NPI | 1114212040 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X (Licence: WI 65519-20) |
| Additional Taxonomies | 2085N0700X (Licence: IL 336.104533) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 65519-20) | |
| Enumeration Date | 2011-06-20 |
| Last Update Date | 2024-02-26 |