| NPI | 1972039352 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: IL 036-164527) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: AZ 56779) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: IN 01095163A) | |
| Enumeration Date | 2017-05-04 |
| Last Update Date | 2025-01-23 |