| NPI | 1174527584 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085B0100X Radiology Body Imaging (Licence: MO MO31097) |
| Additional Taxonomies | 2085B0100X Radiology Body Imaging (Licence: IL 03604249) |
| Enumeration Date | 2005-06-13 |
| Last Update Date | 2008-07-01 |