| NPI | 1437354115 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036.132398) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT190769) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD445059) | |
| Enumeration Date | 2007-06-20 |
| Last Update Date | 2017-03-27 |