| NPI | 1144549692 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MI 4301106929) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IN 11015479A) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 0116023309) | |
| Enumeration Date | 2010-05-24 |
| Last Update Date | 2015-10-23 |