| NPI | 1689965949 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO 57895) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX P6421) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036140085) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 29847) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 04-39648) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: HI MD19108) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-04-21 |
| Last Update Date | 2022-12-12 |