| NPI | 1861791048 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 260808)  | 
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036131016)  | 
| Enumeration Date | 2011-03-27 | 
| Last Update Date | 2019-06-14 |