| NPI | 1912469685 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2085P0229X Radiology, Pediatric Radiology (Licence: IL 036165564)  | 
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX 036165564)  | 
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036165564)  | |
| 208600000X Surgery (Licence: NC 250925)  | |
| Enumeration Date | 2019-04-02 | 
| Last Update Date | 2025-07-22 |