| NPI | 1609578293 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2024-03409) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC AHUJ-6K4K8O) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2023-03-20 |
| Last Update Date | 2024-12-17 |