| NPI | 1619913639 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036-095546) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA C183025) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301507853) | |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2024-05-08 |