| NPI | 1902337108 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036.165113) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: IL 036.165113) |
| 282N00000X General Acute Care Hospital | |
| Enumeration Date | 2017-03-21 |
| Last Update Date | 2025-09-11 |