| NPI | 1821368333 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35.122690) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57.019353) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036139630) | |
| Enumeration Date | 2011-12-31 |
| Last Update Date | 2019-06-07 |