| NPI | 1871500199 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A69528) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036-113223) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA11086100) | |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2024-04-08 |