| NPI | 1932280492 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME20137) |
| Additional Taxonomies | 261QR0206X Clinic/Center, Radiology, Mammography (Licence: FL ME20137) |
| 261QM1200X Clinic/Center, Magnetic Resonance Imaging (MRI) (Licence: FL ME20137) | |
| 261QR0200X Clinic/Center, Radiology (Licence: FL ME20137) | |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2021-10-22 |