| NPI | 1477057958 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085B0100X Radiology, Body Imaging (Licence: PA MD483615) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 208600000X Surgery (Licence: IL 125072137) | |
| Enumeration Date | 2018-03-20 |
| Last Update Date | 2024-07-22 |