| NPI | 1992224018 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X (Licence: UT 12772376-1205) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 125.071595) |
| Enumeration Date | 2017-09-11 |
| Last Update Date | 2022-03-30 |