| NPI | 1093251118 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 287009) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: NY 287009) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY 287009) | |
| Enumeration Date | 2017-01-12 |
| Last Update Date | 2018-07-12 |