| NPI | 1417480336 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A184704) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 125.071627) |
| Enumeration Date | 2017-04-07 |
| Last Update Date | 2025-04-30 |