| NPI | 1700231107 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: CA A183037) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 299783) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A183037) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD474401) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-05-04 |
| Last Update Date | 2023-10-10 |