| NPI | 1659021632 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207UN0902X Nuclear Medicine, Nuclear Imaging & Therapy (Licence: NY 343351) |
| Additional Taxonomies | 2085N0904X (Licence: NY 343351) |
| 207U00000X Nuclear Medicine (Licence: NY 343351) | |
| 208600000X Surgery (Licence: NY 343351) | |
| 2085R0203X Radiology, Therapeutic Radiology (Licence: NY 343351) | |
| 261QR0200X Clinic/Center, Radiology (Licence: NY 343351) | |
| Enumeration Date | 2022-03-24 |
| Last Update Date | 2026-08-23 |