| NPI | 1922046242 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: ND 12550) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD033369E) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA05265300) | |
| 207U00000X Nuclear Medicine (Licence: PA MD033369E) | |
| 207U00000X Nuclear Medicine (Licence: NJ 25MA05265300) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME112875) | |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2012-11-13 |