| NPI | 1740574748 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036.142179)  | 
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: IL 036142179)  | 
| Enumeration Date | 2011-06-07 | 
| Last Update Date | 2022-04-13 |