| NPI | 1356898654 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PR 22827) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 110080) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: AL 44398) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: SC 96143) | |
| Enumeration Date | 2016-09-02 |
| Last Update Date | 2026-05-07 |