| NPI | 1679955173 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology Neuroradiology (Licence: IL 125067427) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.067427) |
| Enumeration Date | 2015-06-22 |
| Last Update Date | 2020-06-30 |