| NPI | 1942482245 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207UN0902X Nuclear Medicine, Nuclear Imaging & Therapy (Licence: NV 20109) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: PA MD438516) |
| 207U00000X Nuclear Medicine (Licence: NJ 25MA08695600) | |
| 2085N0904X (Licence: NJ 25MA08695600) | |
| 2085N0904X (Licence: PA MD438516) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA08695600) | |
| Enumeration Date | 2007-11-29 |
| Last Update Date | 2026-05-22 |