NPI | 1134546930 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 201502473) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
2085N0700X Radiology, Neuroradiology (Licence: NC 201502473) | |
Enumeration Date | 2014-03-19 |
Last Update Date | 2016-08-26 |