| NPI | 1518997220 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IA 36645) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036-111854) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A105258) | |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2015-07-21 |