NPI | 1508390097 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0102207098) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA OT018684) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2017-04-12 |
Last Update Date | 2022-07-06 |