| NPI | 1609070945 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NV 12638) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301079553) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036117717) | |
| Enumeration Date | 2007-06-12 |
| Last Update Date | 2011-04-04 |