| NPI | 1306287396 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D0080742) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301103766) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NC 2025-00284) | |
| 207U00000X Nuclear Medicine (Licence: IL 036156758) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA10317500) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036156758) | |
| 207U00000X Nuclear Medicine (Licence: MD D0080742) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: IL 036156758) | |
| Enumeration Date | 2013-07-08 |
| Last Update Date | 2026-08-27 |