NPI | 1558623512 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NY 301102) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD461454) |
2085R0204X Radiology, Vascular & Interventional Radiology (Licence: PA MD461454) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2012-06-14 |
Last Update Date | 2020-03-01 |