| NPI | 1538911607 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AL L.6262R) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AL L.6262R) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2024-04-03 |
| Last Update Date | 2025-07-07 |