| NPI | 1447703103 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO DR.0068293) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: LA 302953) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: LA 329372) | |
| Enumeration Date | 2016-07-29 |
| Last Update Date | 2023-04-28 |