| NPI | 1275980856 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036159004) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MT210938) |
| 208600000X Surgery (Licence: PA MT210938) | |
| Enumeration Date | 2016-05-24 |
| Last Update Date | 2022-05-18 |