| NPI | 1730166604 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085D0003X Radiology, Diagnostic Neuroimaging (Licence: CA C53295) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA C53295) |
| 2085N0700X (Licence: CA C53295) | |
| 2085N0700X (Licence: IL 36113620) | |
| Enumeration Date | 2005-12-30 |
| Last Update Date | 2026-03-26 |