| NPI | 1417480419 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: IL 036163728) |
| Additional Taxonomies | 208600000X Surgery (Licence: AZ 57089) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 57089) | |
| 208600000X Surgery (Licence: AZ R76006) | |
| Enumeration Date | 2017-04-06 |
| Last Update Date | 2023-05-22 |