| NPI | 1760470322 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD071123L) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME159266) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2022049597) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036158936) | |
| Enumeration Date | 2005-10-07 |
| Last Update Date | 2025-07-23 |