| NPI | 1861559114 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207U00000X Nuclear Medicine (Licence: NY 238354) |
| Additional Taxonomies | 207UN0902X Nuclear Medicine, Nuclear Imaging & Therapy (Licence: NY 238354) |
| 2085B0100X Radiology, Body Imaging (Licence: NY 238354) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 238354) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NY 238354) | |
| Enumeration Date | 2007-01-03 |
| Last Update Date | 2007-07-08 |