| NPI | 1750679817 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: OR MD181626) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE TEP 6481) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: IL 125.060972) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: CA 139780) | |
| Enumeration Date | 2011-07-11 |
| Last Update Date | 2023-04-17 |