| NPI | 1114172004 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085P0229X Radiology, Pediatric Radiology (Licence: WI 57215) |
| Additional Taxonomies | 2085P0229X Radiology, Pediatric Radiology (Licence: IL 036.127452) |
| Enumeration Date | 2008-11-19 |
| Last Update Date | 2024-03-08 |