| NPI | 1205253549 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 58097) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125065375) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME-139803) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL TRN-22023) | |
| Enumeration Date | 2014-03-25 |
| Last Update Date | 2021-11-09 |