| NPI | 1437385341 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CT 050086) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 284208) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 257955) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-06-05 |
| Last Update Date | 2024-04-30 |