| NPI | 1366487399 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036-062091) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 21400) |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2024-12-15 |