| NPI | 1861802316 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036-164889) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX S5680) |
| Enumeration Date | 2014-05-06 |
| Last Update Date | 2024-01-30 |