| NPI | 1720583354 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: IL 036.169553) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: AL 38682) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: MS 38682) | |
| Enumeration Date | 2018-03-26 |
| Last Update Date | 2024-10-10 |