| NPI | 1699988816 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: MO 2007006284) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: IL 36117741) |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2016-02-08 |