| NPI | 1588346308 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 2085N0904X Radiology, Nuclear Radiology (Licence: OR 918273) |
| Enumeration Date | 2023-08-01 |
| Last Update Date | 2023-08-01 |