| NPI | 1578024865 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: IL 036-162142) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: TX U9537) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: IN 01097271A) | |
| Enumeration Date | 2019-03-28 |
| Last Update Date | 2025-08-22 |