| NPI | 1124294970 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA09451600) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: NJ 25MA09451600) |
| Enumeration Date | 2008-05-01 |
| Last Update Date | 2015-03-26 |