NPI | 1578024865 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX U9537) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
390200000X Student in an Organized Health Care Education/Training Program (Licence: IL 125073674) | |
Enumeration Date | 2019-03-28 |
Last Update Date | 2024-06-27 |