| NPI | 1760682249 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036129124) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME114424) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301090120) | |
| Enumeration Date | 2007-07-23 |
| Last Update Date | 2021-10-08 |