| NPI | 1871974162 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: IL 125066955) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 125066955) |
| 207R00000X Internal Medicine (Licence: IL 125066955) | |
| Enumeration Date | 2015-06-12 |
| Last Update Date | 2021-04-28 |