| NPI | 1154804326 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: IL 125081127) |
| Additional Taxonomies | 208600000X Surgery (Licence: MA 293585) |
| Enumeration Date | 2018-09-12 |
| Last Update Date | 2023-06-14 |