| NPI | 1417395062 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: IL 036145500)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA L-255577)  | 
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A135628)  | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CA A135628)  | |
| Enumeration Date | 2013-06-05 | 
| Last Update Date | 2022-01-06 |