| NPI | 1154690626 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036135106) |
| Additional Taxonomies | 2085D0003X Radiology, Diagnostic Neuroimaging (Licence: IL 036135106) |
| 2085N0700X (Licence: IL 036135106) | |
| Enumeration Date | 2011-12-29 |
| Last Update Date | 2025-03-31 |