| NPI | 1851608756 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: IL 036128375) |
| Additional Taxonomies | 2471C3401X Radiologic Technologist Computed Tomography (Licence: IL 036128375) |
| 2471M1202X Radiologic Technologist Magnetic Resonance Imaging (Licence: IL 036.128375) | |
| Enumeration Date | 2010-09-13 |
| Last Update Date | 2017-03-24 |