| NPI | 1639564479 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036146278) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 73108) |
| Enumeration Date | 2015-03-30 |
| Last Update Date | 2020-07-27 |