| NPI | 1548751878 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL OS21146) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: FL OS21146) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-05-22 |
| Last Update Date | 2024-06-24 |