| NPI | 1508093766 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: NY 284295) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: CA A128343) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 2085D0003X Radiology Diagnostic Neuroimaging (Licence: CA A128343) | |
| 2085N0700X Radiology Neuroradiology (Licence: CA A128343) | |
| Enumeration Date | 2009-06-15 |
| Last Update Date | 2023-01-13 |