| NPI | 1174530737 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: IL 036-057726) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: WI 1058) |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2023-03-03 |