| NPI | 1558650101 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036-142632) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2011018942) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 60184) | |
| Enumeration Date | 2011-04-05 |
| Last Update Date | 2024-01-23 |