| NPI | 1568470961 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 068165) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 036-114640) |
| 207R00000X Internal Medicine (Licence: IL 036-114640) | |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2016-03-03 |