| NPI | 1265639504 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 243U00000X Radiology Practitioner Assistant (Licence: IL 05 IL1144) |
| Additional Taxonomies | 2471C3402X Radiologic Technologist, Radiography (Licence: IL 326686) |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2021-05-04 |