| NPI | 1730178781 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: IL 036104576) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: AZ 30223) |
| Enumeration Date | 2005-10-20 |
| Last Update Date | 2023-11-08 |