| NPI | 1750348934 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036-079214) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX E4300) |
| Enumeration Date | 2006-04-29 |
| Last Update Date | 2011-08-18 |