| 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 | 2023-07-27 |