| NPI | 1699741546 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RM1200X Internal Medicine Magnetic Resonance Imaging (MRI) (Licence: PA OS009600L) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA OS009600) |
| Enumeration Date | 2006-02-28 |
| Last Update Date | 2018-04-09 |