| NPI | 1750349676 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: GA 55385) |
| Additional Taxonomies | 2085P0229X Radiology, Pediatric Radiology (Licence: IL 036-109255) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036-109255) | |
| Enumeration Date | 2006-05-02 |
| Last Update Date | 2022-10-11 |