| NPI | 1083621155 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: MO R4F79) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: IL 036108453) |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2009-03-18 |