| NPI | 1932291309 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OR MD20055) | 
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: WA MD00038143) | 
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036-079566) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME0059661) | |
| Enumeration Date | 2006-09-29 | 
| Last Update Date | 2025-10-30 |