| NPI | 1144312943 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OR DO191292)  | 
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 125062715)  | 
| Enumeration Date | 2006-09-29 | 
| Last Update Date | 2020-11-02 |