| NPI | 1518969906 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: IL 036-054294) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: IA 26909) |
| Enumeration Date | 2005-08-15 |
| Last Update Date | 2009-07-02 |