| NPI | 1235495524 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 68674) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 2013-01333) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 63155) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IA MD-44821) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2013-01333) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-04-11 |
| Last Update Date | 2020-04-07 |