| NPI | 1144361429 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D67824) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MD P16782) |
| Enumeration Date | 2007-02-09 |
| Last Update Date | 2008-07-08 |