| NPI | 1306890728 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: IL 036-074000) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036074000) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 163855-1) | |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2013-05-20 |