| NPI | 1730200890 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: MO 2007022720) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: IL 036-115266) |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2021-01-15 |