| NPI | 1225290802 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: IL 036123614) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: IL 125.051705) |
| Enumeration Date | 2008-06-25 |
| Last Update Date | 2023-11-08 |