| NPI | 1457644718 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 299292-01) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: NY 299292-01) |
| 207U00000X Nuclear Medicine (Licence: NJ 25MA11366200) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA11366200) | |
| Enumeration Date | 2011-05-19 |
| Last Update Date | 2025-01-28 |