NPI | 1578724456 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NY 257995) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
2085R0202X Radiology, Diagnostic Radiology (Licence: NY 257995) | |
2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD452276) | |
Enumeration Date | 2008-06-23 |
Last Update Date | 2015-10-05 |