| NPI | 1194775445 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085P0229X Radiology Pediatric Radiology (Licence: IL 036-088572) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: WI 30528) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: IL 036-088572) | |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2023-08-02 |