| NPI | 1184680449 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 126697) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: NY 126697) |
| 207UN0901X Nuclear Medicine, Nuclear Cardiology (Licence: NY 126697) | |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2015-07-23 |