| NPI | 1508024217 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036164701)  | 
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CA A107013)  | 
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A107013)  | |
| Enumeration Date | 2008-05-29 | 
| Last Update Date | 2023-11-09 |