| NPI | 1174985287 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: IL 036.155721) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: FL ME141909) |
| Enumeration Date | 2016-03-28 |
| Last Update Date | 2021-06-08 |