| NPI | 1407616485 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: IL 125.083215) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.083215) |
| Enumeration Date | 2024-03-19 |
| Last Update Date | 2025-03-27 |