| NPI | 1801356761 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036-167917) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX U9899) |
| Enumeration Date | 2019-03-25 |
| Last Update Date | 2024-06-24 |