| NPI | 1588641104 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: IL 036.095510) |
| Additional Taxonomies | 2471C3402X Radiologic Technologist Radiography |
| 174400000X Specialist (Licence: IL 036095510) | |
| Enumeration Date | 2005-12-23 |
| Last Update Date | 2015-03-06 |