| NPI | 1609308105 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX T9639) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: OR MD221169) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME170736) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 04-49828) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CO DR.0073875) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MT MED-PHYS-LIC-149152) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: UT 14213246-1235) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NH 24502) | |
| Enumeration Date | 2017-04-03 |
| Last Update Date | 2026-02-26 |