| NPI | 1942482245 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD438516) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: PA MD438516) |
| 2085N0904X Radiology, Nuclear Radiology (Licence: PA MD438516) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA08695600) | |
| 207U00000X Nuclear Medicine (Licence: NJ 25MA08695600) | |
| 2085N0904X Radiology, Nuclear Radiology (Licence: NJ 25MA08695600) | |
| Enumeration Date | 2007-11-29 |
| Last Update Date | 2011-01-05 |