| NPI | 1740803790 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207U00000X Nuclear Medicine (Licence: PA MD487455) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: NJ 25IA13137500) |
| Enumeration Date | 2020-05-26 |
| Last Update Date | 2026-08-13 |