| NPI | 1932194545 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX P0590) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL OS9283) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036115069) | |
| Enumeration Date | 2005-09-20 |
| Last Update Date | 2025-06-19 |