| NPI | 1164753273 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036.128059) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 249897) |
| Enumeration Date | 2010-01-29 |
| Last Update Date | 2012-04-02 |