| NPI | 1427671445 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036173771) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NE TBA) |
| Enumeration Date | 2020-05-26 |
| Last Update Date | 2025-04-09 |