| NPI | 1174835003 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036134688) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: AZ 56922) |
| 207UN0902X Nuclear Medicine, Nuclear Imaging & Therapy (Licence: NY 275316) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A169326) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 56922) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 275316) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301096774) | |
| Enumeration Date | 2010-07-08 |
| Last Update Date | 2023-12-06 |