| NPI | 1124052253 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 2344951) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD417713) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA07251900) | |
| 207U00000X Nuclear Medicine (Licence: PA MD417713) | |
| 207U00000X Nuclear Medicine (Licence: NJ 25MA07251900) | |
| 2085N0700X (Licence: PA MD417713) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: PA MD417713) | |
| 2085N0700X (Licence: NJ 25MA07251900) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NJ 25MA07251900) | |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2014-09-11 |