| NPI | 1154556520 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2015005945) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01077933A) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 157393) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036137092) | |
| Enumeration Date | 2009-05-28 |
| Last Update Date | 2022-07-18 |