| NPI | 1053388371 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036114911) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 04-28765) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 200155001) | |
| Enumeration Date | 2006-03-06 |
| Last Update Date | 2022-04-20 |