| NPI | 1750761599 |
|---|---|
| Former Name | NICHOLAS DAVID CORRIDONI |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: PA MD473250) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT208016) |
| Enumeration Date | 2015-06-07 |
| Last Update Date | 2022-05-11 |