| NPI | 1144073867 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: KS 94-11795) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 94-11795) |
| Enumeration Date | 2024-04-10 |
| Last Update Date | 2025-04-24 |