| NPI | 1184987356 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036-146487) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CT 66257) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: KY 54687) | |
| Enumeration Date | 2012-06-21 |
| Last Update Date | 2021-01-06 |