| NPI | 1558372359 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 64739) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO 42291) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036-159139) | |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2023-11-27 |