| NPI | 1609121219 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: IL 036151026) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 36.151026) |
| Enumeration Date | 2012-07-19 |
| Last Update Date | 2026-04-09 |