| NPI | 1053336156 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: IL 036-095364) |
| Additional Taxonomies | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: VA 0101239677) |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2025-08-13 |