| NPI | 1386175859 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NH RT-3311) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CT 57410) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-03-25 |
| Last Update Date | 2018-07-10 |