NPI | 1376030825 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX V3136) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MT MED-RES-LIC-67472) |
2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 69345) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2018-04-19 |
Last Update Date | 2024-09-23 |