| NPI | 1366975666 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 81635) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL TRN24706) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036159804) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME137215) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IL D36.159804) | |
| Enumeration Date | 2017-04-04 |
| Last Update Date | 2023-07-19 |