| NPI | 1194016659 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX R1815) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A142432) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036160751) | |
| Enumeration Date | 2011-05-02 |
| Last Update Date | 2022-09-19 |