| NPI | 1235455262 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036151032) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX S7748) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CA 20A14311) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: PA OS020173) | |
| Enumeration Date | 2010-04-15 |
| Last Update Date | 2024-09-30 |