| NPI | 1346827086 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 125.078327) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.078327) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IL None) | |
| Enumeration Date | 2021-03-27 |
| Last Update Date | 2022-06-20 |