| NPI | 1063738243 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 48882) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036144472) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: IL 036144472) | |
| Enumeration Date | 2010-04-14 |
| Last Update Date | 2025-02-24 |