| NPI | 1942797170 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME173370) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: WA MD61408278) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036.160177) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: AK 218276) | |
| Enumeration Date | 2018-04-13 |
| Last Update Date | 2025-09-26 |