| NPI | 1184735797 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 14324020) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IA 15507) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301022344) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036038134) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2007-07-08 |