| NPI | 1093708919 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0904X Radiology Nuclear Radiology (Licence: NY 142577-01) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: NJ 25MA05032106) |
| 207U00000X Nuclear Medicine (Licence: NY 142577-01) | |
| 2085N0904X Radiology Nuclear Radiology (Licence: NJ 25MA05032106) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: NJ 25MA05032106) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: NY 142577-01) | |
| Enumeration Date | 2005-08-25 |
| Last Update Date | 2022-10-19 |