| NPI | 1760429054 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: MO R6146) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: IL 036052082) |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2012-12-04 |