NPI | 1407382377 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: NM MD2022-1486) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX T4098) |
390200000X Student in an Organized Health Care Education/Training Program (Licence: OH 57.029494) | |
Enumeration Date | 2017-05-11 |
Last Update Date | 2024-06-20 |