| NPI | 1013958594 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX D7516) |
| Additional Taxonomies | 207RM1200X Internal Medicine, Magnetic Resonance Imaging (MRI) (Licence: TX D7516) |
| 2085B0100X Radiology, Body Imaging (Licence: TX D7516) | |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2012-11-26 |