NPI | 1649652447 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX S7427) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10054307) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2015-06-29 |
Last Update Date | 2020-09-04 |