| NPI | 1811421167 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME160884) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036.157431) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: DE C1-0026039) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2024049299) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WV 34576) | |
| Enumeration Date | 2017-04-13 |
| Last Update Date | 2025-08-08 |