| NPI | 1508234667 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: OH 35.143719) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: IL 036147834) |
| Enumeration Date | 2015-09-07 |
| Last Update Date | 2022-02-27 |