| NPI | 1205195146 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL OS18277) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: FL OS18277) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 079189) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-05-13 |
| Last Update Date | 2022-07-08 |