| NPI | 1720583024 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OR MD217082) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO DR.0073933) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TX V3634) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 72230) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: UT 14212502-1235) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MT MED-PHYS-LIC-148419) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 04-45483) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2020033901) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME170999) | |
| Enumeration Date | 2018-03-28 |
| Last Update Date | 2026-02-26 |