| NPI | 1619504222 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 80021) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: ND 22571) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 125.077310) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 81943-21) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036164210) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-03-24 |
| Last Update Date | 2025-12-31 |