| NPI | 1346439015 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036.127248) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH student) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D0073409) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301095738) | |
| Enumeration Date | 2007-10-18 |
| Last Update Date | 2015-12-15 |