| NPI | 1538666201 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL OS20406) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036173268) |
| Enumeration Date | 2018-04-10 |
| Last Update Date | 2025-06-24 |