| NPI | 1396134078 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: IL 036155649) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 2085R0001X Radiology, Radiation Oncology (Licence: IL 125069737) | |
| Enumeration Date | 2015-01-17 |
| Last Update Date | 2021-08-03 |