| NPI | 1124822945 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MT236408) |
| Enumeration Date | 2025-04-02 |
| Last Update Date | 2026-05-07 |