| NPI | 1760132963 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: IL 125082203) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: IL 125.082203) |
| Enumeration Date | 2022-03-28 |
| Last Update Date | 2023-07-11 |