| NPI | 1629023700 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 36082388) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 25.000020) |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2014-01-23 |