| NPI | 1568618668 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 125050771) | 
| Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: MD D0075066) | 
| Enumeration Date | 2008-08-08 | 
| Last Update Date | 2024-07-03 |