| NPI | 1013968163 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036-112483) |
| Additional Taxonomies | 202K00000X (Licence: IL 036112483) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: IL 036-112483) | |
| Enumeration Date | 2006-05-13 |
| Last Update Date | 2023-01-24 |