| NPI | 1508039686 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NM MB2014-0117) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A125160) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-04-09 |
| Last Update Date | 2025-03-13 |