| NPI | 1255301313 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 39364020) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 336054929) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IA 31369) | |
| Enumeration Date | 2006-01-23 |
| Last Update Date | 2017-10-06 |