| NPI | 1831365279 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A107054) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036-118473) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CA A107054) | |
| Enumeration Date | 2008-05-06 |
| Last Update Date | 2010-07-28 |