| NPI | 1184730699 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 186726) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME182010) |
| 207U00000X Nuclear Medicine (Licence: NY 186726) | |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2026-07-30 |