NPI | 1740456458 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 072212) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
2085U0001X Radiology, Diagnostic Ultrasound (Licence: TX p7239) | |
2085B0100X Radiology, Body Imaging (Licence: TX p7239) | |
2085R0202X Radiology, Diagnostic Radiology (Licence: TX p7239) | |
Enumeration Date | 2008-05-02 |
Last Update Date | 2016-03-03 |