| NPI | 1295020758 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX Q7705) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 5101027662) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: TX Q7705) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036-158684) | |
| Enumeration Date | 2011-06-13 |
| Last Update Date | 2024-07-23 |