| NPI | 1265751150 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036-164339) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NV 14773) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 68321) | |
| Enumeration Date | 2010-05-18 |
| Last Update Date | 2023-10-23 |