| NPI | 1962909895 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: IL 036164003) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: IN 01093345A) |
| Enumeration Date | 2018-04-08 |
| Last Update Date | 2024-06-06 |