| NPI | 1871788323 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036120748) | 
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01092537A) | 
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301081973) | |
| Enumeration Date | 2007-09-07 | 
| Last Update Date | 2025-07-09 |