| NPI | 1427518885 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101281510) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.074657) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 125.074657) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TX BP10072483) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-03-21 |
| Last Update Date | 2024-07-01 |