| NPI | 1912232422 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036-131849) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2013005692) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MT190595) | |
| Enumeration Date | 2009-10-16 |
| Last Update Date | 2021-06-29 |