| NPI | 1447453113 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01076476A) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: OH 35.099412) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 0116019178) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: IN 01076476A) | |
| Enumeration Date | 2007-06-08 |
| Last Update Date | 2025-09-17 |