| NPI | 1154900751 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036.180196) |
| Additional Taxonomies | 2085N0700X (Licence: IL 036.180196) |
| 2085D0003X Radiology, Diagnostic Neuroimaging (Licence: IL 036.180196) | |
| Enumeration Date | 2021-04-02 |
| Last Update Date | 2026-06-10 |