| NPI | 1972512754 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA09089800) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 244698) |
| 207UN0902X Nuclear Medicine, Nuclear Imaging & Therapy (Licence: NJ 25MA09089800) | |
| Enumeration Date | 2006-08-07 |
| Last Update Date | 2014-06-26 |