| NPI | 1477909356 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085B0100X Radiology, Body Imaging (Licence: NC 2021-00635) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10056529) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2021-00635) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-05-10 |
| Last Update Date | 2021-06-15 |