| NPI | 1780902395 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: WI 56535) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 56535) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036137359) | |
| Enumeration Date | 2010-05-06 |
| Last Update Date | 2025-04-02 |