| NPI | 1346867215 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 2085U0001X Radiology, Diagnostic Ultrasound (Licence: PR 35610-R) |
| Enumeration Date | 2020-06-26 |
| Last Update Date | 2024-09-04 |