| NPI | 1659756716 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036159807) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 74962) |
| Enumeration Date | 2015-07-29 |
| Last Update Date | 2022-08-22 |