| NPI | 1861810632 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: IL 036.144547) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125065462) |
| Enumeration Date | 2014-03-31 |
| Last Update Date | 2021-12-17 |