| NPI | 1578724894 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: KY 53044)  | 
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036128200)  | 
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01072713A)  | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 125054717)  | |
| Enumeration Date | 2008-06-19 | 
| Last Update Date | 2023-03-07 |