| NPI | 1689085748 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: VT 032.0133800) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI LP02921) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 326325) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-05-12 |
| Last Update Date | 2023-10-24 |