| NPI | 1497071872 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: IL 036-147348) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: OH 35.134522) |
| Enumeration Date | 2010-04-11 |
| Last Update Date | 2024-01-03 |