| NPI | 1043535065 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: IN 01076897A) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: FL ME 112447) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-04-01 |
| Last Update Date | 2021-02-08 |