| NPI | 1316172620 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 52527) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TN MD52527) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: TN MD52527) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: TN MD52527) | |
| Enumeration Date | 2009-05-17 |
| Last Update Date | 2022-10-31 |