| NPI | 1558868356 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2024011987) |
| Enumeration Date | 2018-04-09 |
| Last Update Date | 2024-06-14 |