| NPI | 1700041274 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 55007) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IA 39211) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01066886) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 53517) | |
| Enumeration Date | 2008-07-24 |
| Last Update Date | 2018-04-13 |