| NPI | 1942492475 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 125-052437) |
| Additional Taxonomies | 2085N0700X (Licence: IA 40110) |
| 2085N0700X (Licence: IL 036125189) | |
| Enumeration Date | 2007-08-17 |
| Last Update Date | 2024-01-03 |