| NPI | 1174787220 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036.132851)  | 
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A99624)  | 
| Enumeration Date | 2008-07-17 | 
| Last Update Date | 2013-06-18 |