| NPI | 1710448634 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC RTL24-0746) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: NC RTL24-0746) |
| Enumeration Date | 2019-03-26 |
| Last Update Date | 2024-11-06 |