| NPI | 1356362719 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: TX M4442) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: IL 125-042933) |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2019-05-23 |