| NPI | 1922395524 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: IL 036.143738) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 125-0600487) |
| Enumeration Date | 2011-07-01 |
| Last Update Date | 2019-03-13 |