| NPI | 1437441250 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: FL ME118757) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL TRN16039) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-05-12 |
| Last Update Date | 2022-07-21 |