| NPI | 1598028367 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A130898) |
| Additional Taxonomies | 2085N0700X (Licence: GA 80588) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 80588) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-06-18 |
| Last Update Date | 2025-07-02 |