| NPI | 1447697396 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 69413) |
| Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: IL 036.143566) |
| Enumeration Date | 2013-06-02 |
| Last Update Date | 2018-07-11 |