| NPI | 1467716068 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 125061872) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: OR MD187261) |
| Enumeration Date | 2012-06-27 |
| Last Update Date | 2026-04-02 |