| NPI | 1275533234 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: NJ 25MA07124600) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: NJ 25MA07124600) |
| 2085N0904X Radiology Nuclear Radiology (Licence: NJ 25MA07124600) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: PA MD048348L) | |
| Enumeration Date | 2005-07-29 |
| Last Update Date | 2024-05-02 |