| NPI | 1902082753 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 55393) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036.119871) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: IL 036119871) | |
| Enumeration Date | 2008-01-10 |
| Last Update Date | 2015-01-12 |