| NPI | 1750437349 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO 43709) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 04-39808) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 29857) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: CO DR-43709) | |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2022-07-21 |