NPI | 1245799170 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: TX U6528) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2019-03-19 |
Last Update Date | 2024-06-19 |