| NPI | 1639704836 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036178323) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.078976) |
| Enumeration Date | 2020-03-08 |
| Last Update Date | 2026-05-28 |