NPI | 1073990644 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: AL MD.48566) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME144525) |
2085R0204X Radiology, Vascular & Interventional Radiology (Licence: FL ME144525) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2015-05-02 |
Last Update Date | 2024-04-09 |