| NPI | 1063947919 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085U0001X Radiology, Diagnostic Ultrasound (Licence: OH 34.017262) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: AL 2350) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-04-28 |
| Last Update Date | 2024-06-14 |