| NPI | 1801031547 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME164142) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: FL ME164142) |
| 2085N0700X Radiology, Neuroradiology (Licence: IL 036-120198) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036-120198) | |
| Enumeration Date | 2008-12-09 |
| Last Update Date | 2024-10-28 |