| NPI | 1174630099 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036-084644) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 33015) |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2021-03-15 |