| NPI | 1821098906 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: IL 036095648) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: TX V2782) |
| Enumeration Date | 2005-07-29 |
| Last Update Date | 2024-08-30 |