NPI | 1558892240 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO DR.0074034) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 321090-01) |
390200000X Student in an Organized Health Care Education/Training Program (Licence: CT 60851) | |
Enumeration Date | 2017-03-23 |
Last Update Date | 2025-06-02 |