| NPI | 1003892613 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207U00000X Nuclear Medicine (Licence: NJ 25MA07841600) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: NY 194637-1) |
| Enumeration Date | 2005-12-16 |
| Last Update Date | 2025-05-06 |