NPI | 1346702750 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 125.073706) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.073706) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2019-04-03 |
Last Update Date | 2020-07-04 |