| NPI | 1619040847 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: NJ MA0795530) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: NJ MA0795530) |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2008-05-07 |