NPI | 1033675830 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0102206445) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA12352100) |
208D00000X General Practice (Licence: VA 0102206445) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2019-02-16 |
Last Update Date | 2024-11-18 |