| NPI | 1851617146 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD448576) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 72109) |
| 2085B0100X Radiology, Body Imaging (Licence: IL 036.162243) | |
| Enumeration Date | 2010-04-13 |
| Last Update Date | 2026-04-07 |