| NPI | 1487629929 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX K5677) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2021003847) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036153832) | |
| Enumeration Date | 2006-02-20 |
| Last Update Date | 2023-10-09 |