| NPI | 1487092284 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0205X Radiology, Radiological Physics (Licence: FL mpt273) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2013-06-13 |
| Last Update Date | 2015-07-31 |