| NPI | 1922080399 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X (Licence: IL 036068882) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036068882) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 25000041) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01060991A) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 34114) | |
| Enumeration Date | 2005-11-18 |
| Last Update Date | 2011-11-14 |