| NPI | 1811519465 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 125078829) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: IL 125078829) |
| 208600000X Surgery (Licence: FL TRN31149) | |
| Enumeration Date | 2020-05-16 |
| Last Update Date | 2023-05-23 |