| NPI | 1831359512 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036146753) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 25502) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2018018425) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301107866) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-06-16 |
| Last Update Date | 2022-08-22 |