| NPI | 1295777563 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036-122191) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: KY 34939) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA12169000) | |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2024-05-22 |