| NPI | 1750570552 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036128662) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CA a96996) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 54664) | |
| Enumeration Date | 2007-10-17 |
| Last Update Date | 2013-08-14 |