NPI | 1326601600 |
---|---|
Other Name | JAKE BOWERS |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: GA 13285) |
Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: GA 13285) |
Enumeration Date | 2019-04-22 |
Last Update Date | 2022-06-21 |