| NPI | 1548688708 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME144379) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 103864) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101284692) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-04-03 |
| Last Update Date | 2025-08-18 |