| NPI | 1669490090 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX M4564) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036144474) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2025021784) | |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2025-08-05 |