| NPI | 1639410301 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: IN 02006154A) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: NY 299215) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-03-06 |
| Last Update Date | 2021-02-23 |