| NPI | 1245686898 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036168112) | 
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 95697) | 
| 208D00000X General Practice (Licence: PA MD466052) | |
| Enumeration Date | 2016-05-12 | 
| Last Update Date | 2024-12-17 |