NPI | 1295116721 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OK 38165) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
207R00000X Internal Medicine (Licence: MO 2015017892) | |
Enumeration Date | 2015-06-10 |
Last Update Date | 2021-07-30 |