| NPI | 1598223471 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: FL TRN33650) |
| Additional Taxonomies | 208600000X Surgery (Licence: FL TRN33650) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-03-08 |
| Last Update Date | 2022-07-11 |