| NPI | 1215249545 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: IL 036131855) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: CT 53962) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: WI 81184) | |
| Enumeration Date | 2010-07-01 |
| Last Update Date | 2022-12-20 |