| NPI | 1982639621 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085U0001X Radiology Diagnostic Ultrasound (Licence: IL 036101068) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: MA 281929) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: NM MD2018-0966) | |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2024-10-22 |