NPI | 1376991869 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085N0700X Radiology Neuroradiology (Licence: NC 2021-02067) |
Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: NC 2021-02067) |
2085R0202X Radiology Diagnostic Radiology (Licence: PA MD469163) | |
2085R0202X Radiology Diagnostic Radiology (Licence: VA 0101274699) | |
390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT211009) | |
Enumeration Date | 2016-05-25 |
Last Update Date | 2024-09-27 |