| NPI | 1225393804 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: IL 000000000) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 125.061269) |
| Enumeration Date | 2012-07-10 |
| Last Update Date | 2021-12-27 |