| NPI | 1700172905 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 70979) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036139582) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2015032299) | |
| Enumeration Date | 2011-06-26 |
| Last Update Date | 2022-07-07 |