| NPI | 1356508600 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MS 24588) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2013-01343) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-05-22 |
| Last Update Date | 2022-01-25 |