| NPI | 1861810632 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301516253) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125065462) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036.144547) | |
| Enumeration Date | 2014-03-31 |
| Last Update Date | 2026-05-13 |