| NPI | 1184885543 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: NY 263250) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: ND 13854) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: PA MD444314) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: MN 104490) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: MN 52339) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-06-18 |
| Last Update Date | 2022-03-31 |