| NPI | 1699762369 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: IL 036-053960) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: IA 22899) |
| Enumeration Date | 2005-09-28 |
| Last Update Date | 2022-02-10 |