| NPI | 1548589732 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35128150) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01077811A) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-05-27 |
| Last Update Date | 2021-01-13 |