| NPI | 1447853262 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX T9345) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX BP10071322) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP10071322) | |
| Enumeration Date | 2020-11-17 |
| Last Update Date | 2023-04-26 |