| NPI | 1316113228 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: UT 10926114-1205) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2010-00277) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OR MD153988) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: ID M-11249) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 135137) | |
| Enumeration Date | 2008-05-01 |
| Last Update Date | 2023-12-08 |