| NPI | 1922039585 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 178677) | 
| Additional Taxonomies | 207UN0901X Nuclear Medicine, Nuclear Cardiology (Licence: NY 178677) | 
| 2085N0904X (Licence: NY 178677) | |
| Enumeration Date | 2006-07-05 | 
| Last Update Date | 2022-01-08 |