| NPI | 1619210820 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: IL 036.146119) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.063386) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: IL 125.063386) | |
| Enumeration Date | 2013-04-05 |
| Last Update Date | 2018-07-02 |