Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207U00000X | Nuclear Medicine Specialist | A98014 | CA |
NPI | 1548431497 |
---|---|
Provider Name | Eduardo Moroni |
First Address | Danville, PA 17822-4903 |
Second Address | Wilkes Barre, PA 18711-3446 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/03/2008 |
Last Update Date | 23/08/2016 |