| NPI | 1578893947 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 89546) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036.136790) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA08479200) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D74221) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 256404) | |
| Enumeration Date | 2010-01-07 |
| Last Update Date | 2022-02-08 |