| NPI | 1699723965 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036073628) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2020031768) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 30890) | |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2022-10-28 |