| NPI | 1326257064 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: ID O-0616) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: OR DO154120) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 125049736) | |
| 2085B0100X Radiology, Body Imaging (Licence: IA 4081) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IA 4081) | |
| 2085U0001X Radiology, Diagnostic Ultrasound (Licence: IA 4081) | |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2011-11-30 |