| NPI | 1063774735 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085P0229X Radiology, Pediatric Radiology (Licence: IL 036145143) |
| Additional Taxonomies | 2085P0229X Radiology, Pediatric Radiology (Licence: MA 270133) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036145143) | |
| 208D00000X General Practice (Licence: OK 30030) | |
| Enumeration Date | 2012-06-08 |
| Last Update Date | 2026-02-20 |