| NPI | 1740817261 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2025-03621) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: SC LL84285) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101285232) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 125077323) | |
| Enumeration Date | 2020-03-25 |
| Last Update Date | 2025-11-03 |