| NPI | 1295149565 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: RI MD15531) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: MA 277930) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: RI LP03316) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: MA 260036) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-06-16 |
| Last Update Date | 2024-03-08 |