| NPI | 1316171184 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 264814) |
| Additional Taxonomies | 2085N0904X Radiology, Nuclear Radiology (Licence: NY 264814) |
| 2085N0904X Radiology, Nuclear Radiology (Licence: MA 240427) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 240427) | |
| 207U00000X Nuclear Medicine (Licence: MA 240427) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MA 240427) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NY 264814) | |
| Enumeration Date | 2009-05-08 |
| Last Update Date | 2021-05-05 |