| NPI | 1780876177 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036129663) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME133965) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2013038716) | |
| Enumeration Date | 2007-08-09 |
| Last Update Date | 2021-08-09 |