NPI | 1184035693 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MA 284683) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
2085R0202X Radiology, Diagnostic Radiology (Licence: MA 284683) | |
Enumeration Date | 2014-05-19 |
Last Update Date | 2024-09-09 |