NPI | 1730575754 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: CA A166736) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2015-04-07 |
Last Update Date | 2021-09-30 |