| NPI | 1548435811 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A189918) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301090857) |
| 207U00000X Nuclear Medicine (Licence: MI 4301090857) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-04-28 |
| Last Update Date | 2023-09-08 |