NPI | 1417512005 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 67694) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: OR PG193629) |
Enumeration Date | 2019-05-08 |
Last Update Date | 2020-09-30 |