| NPI | 1851778674 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036-157557) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: WV 27931) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D88788) | |
| Enumeration Date | 2015-04-30 |
| Last Update Date | 2023-11-27 |