| NPI | 1164728820 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NH 23922) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME110292) |
| 207RM1200X Internal Medicine, Magnetic Resonance Imaging (MRI) (Licence: FL ME110292) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: ND 23965) | |
| Enumeration Date | 2011-01-28 |
| Last Update Date | 2026-04-21 |