| NPI | 1235391616 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036127536) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MS 696-L) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2012015952) | |
| Enumeration Date | 2008-06-27 |
| Last Update Date | 2021-06-29 |