| NPI | 1447413695 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D76591) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: DC MD042148) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT193407) | |
| Enumeration Date | 2008-07-08 |
| Last Update Date | 2026-06-03 |