| NPI | 1194068460 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036148302) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 294686) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CT 66394) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: KY 54609) | |
| Enumeration Date | 2013-04-04 |
| Last Update Date | 2022-09-19 |