| NPI | 1033287776 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301041301) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036055112) |
| 208D00000X General Practice (Licence: MI 4301041301) | |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2023-07-07 |