| NPI | 1275572331 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036-111229) |
| Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: IL 036-111229) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35.087026) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: AL 00023747) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0116010494) | |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2007-10-08 |