| NPI | 1447813308 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036.168624) |
| Additional Taxonomies | 208D00000X General Practice (Licence: MI 4301504706) |
| Enumeration Date | 2019-04-17 |
| Last Update Date | 2024-06-19 |