| NPI | 1083382212 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: IL 125.083105) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 14914) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 125.083105) | |
| Enumeration Date | 2021-09-02 |
| Last Update Date | 2024-05-28 |