| NPI | 1598261588 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL OS19914) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: DE C2-0013299) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CT 74261) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: CT 74668) | |
| Enumeration Date | 2018-03-30 |
| Last Update Date | 2025-01-09 |