| NPI | 1326539727 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 286002) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 275711) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-05-22 |
| Last Update Date | 2024-05-16 |