| NPI | 1649208745 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: FL ME100346) |
| Additional Taxonomies | 207RM1200X Internal Medicine Magnetic Resonance Imaging (MRI) (Licence: FL ME100346) |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2016-02-24 |