| NPI | 1457514697 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036123104) | 
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036.123104) | 
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WA 60372830) | |
| Enumeration Date | 2008-07-08 | 
| Last Update Date | 2021-04-01 |