| 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 Radiology Nuclear Radiology (Licence: NY 178677) | |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2022-01-08 |