| NPI | 1972545655 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 2850) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036.096651) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL OS11561) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 101555) | |
| Enumeration Date | 2006-06-10 |
| Last Update Date | 2024-02-22 |