| NPI | 1710336987 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036153352) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO 2016016960) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35.141667) | |
| Enumeration Date | 2016-06-08 |
| Last Update Date | 2023-04-07 |