| NPI | 1538152129 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: AZ 41078) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036107084) |
| 208000000X Pediatrics (Licence: AZ 41078) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 41078) | |
| Enumeration Date | 2005-08-30 |
| Last Update Date | 2013-01-16 |