| NPI | 1285877233 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO DR.0055098) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101255622) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 73623) | |
| Enumeration Date | 2009-04-07 |
| Last Update Date | 2026-05-01 |