| NPI | 1053730663 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0904X Radiology, Nuclear Radiology (Licence: TX S2000) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10049447) |
| 207U00000X Nuclear Medicine (Licence: TX S2000) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TX S2000) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-04-10 |
| Last Update Date | 2023-01-12 |