| NPI | 1699169771 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: AR E15805) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: MS 27139) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MS T-2965) | |
| Enumeration Date | 2015-03-26 |
| Last Update Date | 2023-11-17 |