| NPI | 1003808635 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 147745-1) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: NY 147745) |
| Enumeration Date | 2005-08-19 |
| Last Update Date | 2008-03-17 |