| NPI | 1871576157 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME124662) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: OK 24407) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036119561) | |
| Enumeration Date | 2005-11-21 |
| Last Update Date | 2015-07-21 |