| NPI | 1699784272 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX G9161) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2021034079) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036147944) | |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2026-02-02 |