NPI | 1740642354 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MN 73752) |
Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: IL 125.077741) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2016-03-23 |
Last Update Date | 2025-06-10 |