NPI | 1649411638 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: TX Q1082) |
Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: OK 27702) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2009-03-20 |
Last Update Date | 2020-10-06 |