| NPI | 1487890117 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME111861) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 255511) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CT 047126) | |
| 207RM1200X Internal Medicine, Magnetic Resonance Imaging (MRI) (Licence: FL ME111861) | |
| Enumeration Date | 2008-12-30 |
| Last Update Date | 2015-02-27 |