| NPI | 1053424192 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085B0100X Radiology, Body Imaging (Licence: NJ 25mb08021500) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL OS10292) |
| 207U00000X Nuclear Medicine (Licence: FL OS10292) | |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2025-04-16 |