| NPI | 1710987169 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 153961-2) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: NY 153961) |
| Enumeration Date | 2005-07-28 |
| Last Update Date | 2015-02-12 |