| NPI | 1902856784 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: NY 117624-1) |
| Additional Taxonomies | 2085U0001X Radiology Diagnostic Ultrasound (Licence: NY 117624-1) |
| 207UN0902X Nuclear Medicine Nuclear Imaging & Therapy (Licence: NY 117624-1) | |
| 2085R0204X Radiology Vascular & Interventional Radiology (Licence: NY 117624-1) | |
| 2085N0904X Radiology Nuclear Radiology (Licence: NY 117624-1) | |
| 2085B0100X Radiology Body Imaging (Licence: NY 117624-1) | |
| 2085N0700X Radiology Neuroradiology (Licence: NY 117624-1) | |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2007-07-08 |