| NPI | 1689791576 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: IL 036107094) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: SC 27239) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: IN 01058353A) | |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2024-06-04 |