| NPI | 1336149319 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: NJ 25MB04275400) |
| Additional Taxonomies | 2085B0100X Radiology Body Imaging (Licence: NJ 25MB04275400) |
| 2085N0904X Radiology Nuclear Radiology (Licence: NJ 25MB04275400) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: PA OS005133L) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: DE C20007195) | |
| 2085U0001X Radiology Diagnostic Ultrasound (Licence: NJ 25MB04275400) | |
| Enumeration Date | 2005-07-29 |
| Last Update Date | 2020-03-23 |