| NPI | 1538326798 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: AZ 50458) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: TN 590014) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: PA MD451243) | |
| Enumeration Date | 2008-05-16 |
| Last Update Date | 2024-03-07 |