| NPI | 1679787279 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 65043) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NH 14816) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA09122600) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2019-05-29 |