| NPI | 1437704608 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: TX BP10069051) |
| Enumeration Date | 2019-08-05 |
| Last Update Date | 2021-09-16 |