| NPI | 1558936088 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: IL 125079177) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PA MT223260) |
| Enumeration Date | 2021-05-26 |
| Last Update Date | 2022-06-15 |