| NPI | 1528289055 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 125-051981) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2012014547) |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2021-06-29 |