NPI | 1154515716 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: IL 036.123106) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME110742) |
2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301084169) | |
2085R0204X Radiology, Vascular & Interventional Radiology (Licence: FL ME110742) | |
Enumeration Date | 2007-08-28 |
Last Update Date | 2020-04-24 |