| NPI | 1659728715 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: AR E-15216) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IN 11018699A) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP10058980) | |
| Enumeration Date | 2016-05-18 |
| Last Update Date | 2022-07-14 |