| NPI | 1407380348 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD477067) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 322903) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-04-18 |
| Last Update Date | 2024-06-07 |