| NPI | 1861461915 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 53558-20) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: WI 53558-20) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036-098939) | |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2022-06-27 |