| NPI | 1770014334 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036-165423) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 71794-20) |
| Enumeration Date | 2017-03-24 |
| Last Update Date | 2023-10-16 |