| NPI | 1962410878 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207U00000X Nuclear Medicine (Licence: NY 1954731) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 1954731) |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2008-02-21 |