| NPI | 1235736463 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35.149784) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: IL 125.075741) |
| 2085N0904X Radiology, Nuclear Radiology (Licence: IL 036-164856) | |
| Enumeration Date | 2020-10-01 |
| Last Update Date | 2024-12-01 |