| NPI | 1760988315 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 125072435) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.072435) |
| Enumeration Date | 2018-04-03 |
| Last Update Date | 2019-07-16 |