NPI | 1447413695 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: DC MD042148) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT193407) |
Enumeration Date | 2008-07-08 |
Last Update Date | 2014-09-25 |