| NPI | 1851373864 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0904X (Licence: NJ 25MA04710400) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: NJ 25MA04710400) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA04710400) | |
| Enumeration Date | 2005-11-16 |
| Last Update Date | 2013-01-10 |