| NPI | 1053436808 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207U00000X Nuclear Medicine (Licence: NJ 25MA08872700) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301085346) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 239095) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA08872700) | |
| 2085N0904X Radiology, Nuclear Radiology (Licence: NJ 25MA08872700) | |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2015-09-02 |