| NPI | 1992090773 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 30027) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE 6500) |
| 2085N0700X Radiology, Neuroradiology (Licence: IL 036139702) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2017011966) | |
| Enumeration Date | 2011-06-09 |
| Last Update Date | 2021-04-01 |