NPI | 1184987513 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A156857) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MA 252373) |
Enumeration Date | 2012-06-20 |
Last Update Date | 2019-05-09 |