| NPI | 1316301773 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IA MD-48595) |
| Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: IA MD-48595) |
| 2085B0100X Radiology, Body Imaging (Licence: IL 036.151240) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TX T8857) | |
| Enumeration Date | 2016-04-11 |
| Last Update Date | 2022-07-25 |