| NPI | 1881987972 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 125-060792) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT199378) |
| Enumeration Date | 2011-05-23 |
| Last Update Date | 2015-10-12 |