| NPI | 1801236617 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036150541) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2013018930) |
| 207R00000X Internal Medicine (Licence: MO 2014034042) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2014034042) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: CT 61241) | |
| Enumeration Date | 2013-06-26 |
| Last Update Date | 2019-12-04 |