| NPI | 1740260371 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA OS003194L) |
| Additional Taxonomies | 2085N0904X Radiology, Nuclear Radiology (Licence: PA OS003194L) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MB03400800) | |
| 2085N0904X Radiology, Nuclear Radiology (Licence: NJ 25MB03400800) | |
| 207U00000X Nuclear Medicine (Licence: PA OS003194L) | |
| 207U00000X Nuclear Medicine (Licence: NJ 25MB03400800) | |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2016-01-19 |