| NPI | 1730541046 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: KY 05015) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: KY R4046) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 34.015049) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-03-25 |
| Last Update Date | 2022-04-27 |