| NPI | 1649388729 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X (Licence: MA 224090) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 224090) |
| 208000000X Pediatrics (Licence: MA 224090) | |
| 2085R0203X Radiology, Therapeutic Radiology (Licence: IL 036.121043) | |
| 2085R0203X Radiology, Therapeutic Radiology (Licence: MA 224090) | |
| Enumeration Date | 2006-08-28 |
| Last Update Date | 2015-09-10 |