| NPI | 1083067755 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: DE C1-0024958) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: DE C1-0024958) |
| 2085N0700X Radiology, Neuroradiology (Licence: PA MD476929) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: DE C1-0024958) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD476929) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: PA MD476929) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-07-19 |
| Last Update Date | 2023-01-31 |