| NPI | 1992704381 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 36-087374) |
| Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine (Licence: IL 036-087374) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: IL 36-087374) | |
| 2085U0001X Radiology, Diagnostic Ultrasound (Licence: IL 36-087374) | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2005-07-18 |
| Last Update Date | 2018-03-23 |