| NPI | 1366642738 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 5101017227) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036132515) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2017018162) | |
| Enumeration Date | 2007-07-23 |
| Last Update Date | 2026-03-02 |