| NPI | 1538114616 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036-092976) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NV 12259) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 25.000023) | |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2022-04-27 |