| NPI | 1366766974 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036.135896) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01077824A) |
| Enumeration Date | 2010-03-25 |
| Last Update Date | 2017-02-22 |