| NPI | 1376821082 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: WI 69712) |
| Additional Taxonomies | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: IL 036144074) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: WI 69712) | |
| Enumeration Date | 2011-07-29 |
| Last Update Date | 2024-09-06 |