| NPI | 1275160426 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program | 
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 02008369A) | 
| Enumeration Date | 2020-03-26 | 
| Last Update Date | 2025-10-21 |