| NPI | 1891749701 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 36-039981) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 77972-20) |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2024-05-23 |