| NPI | 1659341337 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: KY 32974) |
| Additional Taxonomies | 2085N0700X (Licence: KY 32974) |
| 2085N0700X (Licence: MI 4301086981) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301086981) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036114899) | |
| Enumeration Date | 2006-01-25 |
| Last Update Date | 2025-11-25 |