| NPI | 1457771909 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO DR.0064058) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: OK 32345) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WY TL6554) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 33229) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 315396) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-04-23 |
| Last Update Date | 2024-08-14 |