| NPI | 1811220007 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: MI 4301108569) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125056692) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: IL 036.130613) | |
| Enumeration Date | 2009-09-07 |
| Last Update Date | 2019-06-07 |