| NPI | 1205152113 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036.136432) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10036772) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: LA MD.204942) | |
| Enumeration Date | 2010-04-16 |
| Last Update Date | 2018-08-07 |