| NPI | 1548963713 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 125.081251) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.081251) |
| Enumeration Date | 2023-03-24 |
| Last Update Date | 2024-07-01 |