| NPI | 1689255325 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036171440) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125077608) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-04-15 |
| Last Update Date | 2024-12-14 |