| NPI | 1982690830 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036-112940) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 02002962) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 46602-021) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NV DO1391) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 34.009265) | |
| Enumeration Date | 2005-09-26 |
| Last Update Date | 2008-04-16 |