| NPI | 1639626138 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: IL 125.076133) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036174741) |
| Enumeration Date | 2016-09-01 |
| Last Update Date | 2025-05-16 |