| NPI | 1902193873 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036-145159) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2011014913) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A136709) | |
| Enumeration Date | 2011-06-29 |
| Last Update Date | 2018-09-12 |