| NPI | 1265756233 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: IL 036.140204) |
| Additional Taxonomies | 2085P0229X Radiology, Pediatric Radiology (Licence: TX R1929) |
| 2085P0229X Radiology, Pediatric Radiology (Licence: IL 036.140204) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TX R1929) | |
| Enumeration Date | 2010-03-19 |
| Last Update Date | 2021-09-16 |