| NPI | 1508062837 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036132363) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301103333) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IA R-9341) | |
| Enumeration Date | 2007-06-24 |
| Last Update Date | 2013-06-26 |