| NPI | 1750733614 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: FL ME155790) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301110641) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-07-04 |
| Last Update Date | 2023-05-09 |