| NPI | 1316574270 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OK 7303) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX V5845) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX V5845) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-03-23 |
| Last Update Date | 2025-05-08 |