| NPI | 1154498244 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: AZ 35626) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: IL 036057113) |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2010-04-09 |