| NPI | 1174084073 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: IL 036.168649) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: WI 77979) |
| Enumeration Date | 2019-03-25 |
| Last Update Date | 2024-09-27 |