NPI | 1699906669 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CA A121425) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036.124012) |
2085R0202X Radiology, Diagnostic Radiology (Licence: CA A121425) | |
Enumeration Date | 2009-08-07 |
Last Update Date | 2012-06-20 |