| NPI | 1710208442 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01072630A) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME123139) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL ME123139) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: IN 01072630A) | |
| Enumeration Date | 2010-06-16 |
| Last Update Date | 2021-03-03 |