NPI | 1255539326 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A106513) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NV LL1815) |
Enumeration Date | 2007-07-10 |
Last Update Date | 2015-09-24 |