NPI | 1578768131 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085N0700X (Licence: MN 79257) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 60302-20) |
390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301090426) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2007-06-15 |
Last Update Date | 2025-08-27 |