| NPI | 1407891633 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA 25782) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036108441) |
| 2085N0700X (Licence: IL 036108441) | |
| Enumeration Date | 2006-06-19 |
| Last Update Date | 2026-08-04 |