| NPI | 1861923369 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: IL 036160182) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: MI 4301114406) |
| Enumeration Date | 2017-03-25 |
| Last Update Date | 2022-06-28 |