| NPI | 1477990521 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD468684) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 5315064924) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NH 18963) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-05-30 |
| Last Update Date | 2024-05-16 |