| NPI | 1568045581 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2022-02076) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2026031160) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036179415) | |
| Enumeration Date | 2021-04-29 |
| Last Update Date | 2026-08-12 |