| NPI | 1629161302 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207U00000X Nuclear Medicine (Licence: NJ 25MA06898300) |
| Additional Taxonomies | 2085N0904X (Licence: NJ MA68983) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ MA68983) | |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2019-09-11 |