| NPI | 1487897153 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: CO CDR.0001157) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: CA 131703) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-04-10 |
| Last Update Date | 2024-06-24 |