| NPI | 1437385507 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: MN 71311) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: CA A114762) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: CA A114762) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: SC 37895) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-06-03 |
| Last Update Date | 2022-09-23 |