| NPI | 1396056321 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036159065) | 
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301508455) | 
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 262871) | |
| Enumeration Date | 2010-06-24 | 
| Last Update Date | 2024-03-19 |