NPI | 1699186775 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: GA 86737) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 86737) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2014-05-12 |
Last Update Date | 2021-06-17 |