| NPI | 1245572726 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: RI MD17819) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MA 288250) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 288250) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: RI MD17819) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NY 297549) | |
| Enumeration Date | 2013-03-21 |
| Last Update Date | 2021-11-05 |