| NPI | 1538699749 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: PA MD479565) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IN 11019908A) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT214357) | |
| Enumeration Date | 2017-06-20 |
| Last Update Date | 2023-05-29 |