| NPI | 1588927065 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036-145703) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IA 45266) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 69346-20) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2017008995) | |
| Enumeration Date | 2012-06-20 |
| Last Update Date | 2018-06-19 |