| NPI | 1750303335 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MO R5H85)  | 
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036112438)  | 
| Enumeration Date | 2006-07-24 | 
| Last Update Date | 2009-03-18 |