NPI | 1073807293 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085P0229X Radiology, Pediatric Radiology (Licence: MI 4301099053) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301099053) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2011-06-06 |
Last Update Date | 2020-09-22 |