NPI | 1508285586 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A149438) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301501847) | |
Enumeration Date | 2014-04-07 |
Last Update Date | 2024-05-17 |