| NPI | 1881644359 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2085B0100X Radiology, Body Imaging (Licence: NJ 25MA08073200)  | 
| Additional Taxonomies | 2085U0001X Radiology, Diagnostic Ultrasound (Licence: NJ 25MA08073200)  | 
| 2085N0700X  (Licence: NJ 25MA08073200)  | |
| 2085N0904X  (Licence: NJ 25MA08073200)  | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA08073200)  | |
| 2085P0229X Radiology, Pediatric Radiology (Licence: NJ 25MA088073200)  | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NJ 25MA08073200)  | |
| 207U00000X Nuclear Medicine (Licence: NJ 25MA080873200)  | |
| 207UN0901X Nuclear Medicine, Nuclear Cardiology (Licence: NJ 25MA08073200)  | |
| 207UN0902X Nuclear Medicine, Nuclear Imaging & Therapy (Licence: NJ 25MA08073200)  | |
| 207UN0903X Nuclear Medicine, In Vivo & In Vitro Nuclear Medicine (Licence: NJ 25MA08073200)  | |
| Enumeration Date | 2006-05-12 | 
| Last Update Date | 2019-02-19 |