| NPI | 1578057030 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301502563) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301114500) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4351033082) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-06-19 |
| Last Update Date | 2024-06-24 |