| NPI | 1609194547 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: TN 61836) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: TN 61836) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-05-16 |
| Last Update Date | 2024-01-24 |