NPI | 1497379606 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: IL 125.077292) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2020-06-03 |
Last Update Date | 2021-08-16 |