| NPI | 1871984823 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: IL 036157012) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 2085R0204X Radiology Vascular & Interventional Radiology (Licence: IL 036-157012) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: IL 125067279) | |
| Enumeration Date | 2015-02-12 |
| Last Update Date | 2024-03-19 |