| NPI | 1114456902 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036160674) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 125.071686) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: IN 11019358A) | |
| Enumeration Date | 2017-06-06 |
| Last Update Date | 2022-07-25 |