| NPI | 1568726826 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: WI 66767) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: IL 125061195) |
| Enumeration Date | 2012-07-01 |
| Last Update Date | 2022-07-21 |