| NPI | 1922366632 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME136012) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2017013059) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036151429) | |
| Enumeration Date | 2012-05-01 |
| Last Update Date | 2024-04-25 |