| NPI | 1053383786 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 230429) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: AL 00007599) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME23293) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101-021130) | |
| Enumeration Date | 2006-02-06 |
| Last Update Date | 2023-02-20 |