NPI | 1639587892 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME157442) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 88588) |
2085R0204X Radiology, Vascular & Interventional Radiology (Licence: GA 88588) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2014-07-31 |
Last Update Date | 2022-08-04 |