| NPI | 1710614276 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207U00000X Nuclear Medicine (Licence: NY 293181) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 293181) |
| 207UN0902X Nuclear Medicine, Nuclear Imaging & Therapy (Licence: NY 293181) | |
| Enumeration Date | 2022-08-04 |
| Last Update Date | 2022-08-04 |