| NPI | 1982652095 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: FL ME67910) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME67910) |
| 207RM1200X Internal Medicine, Magnetic Resonance Imaging (MRI) (Licence: FL 67910) | |
| 202K00000X (Licence: FL ME67910) | |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2016-02-24 |