| NPI | 1811131089 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036138786) | 
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2015026118) | 
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TX p1126) | |
| Enumeration Date | 2009-05-01 | 
| Last Update Date | 2023-11-27 |