| NPI | 1124477237 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301502688) |
| Additional Taxonomies | 2085N0700X (Licence: IL 036.156081) |
| Enumeration Date | 2016-06-09 |
| Last Update Date | 2022-08-01 |