| NPI | 1306137153 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: IL 036146602) |
| Additional Taxonomies | 2085N0700X Radiology Neuroradiology (Licence: UT 8414907-1205) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: UT 8414907-1205) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-04-27 |
| Last Update Date | 2021-04-20 |