| NPI | 1700906997 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology Neuroradiology (Licence: MI 4301087351) |
| Additional Taxonomies | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: MI 4301087351) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301087351) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: IL 036130909) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: MI 4301087351) | |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2019-04-02 |