| NPI | 1770080251 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX U8744) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NH 34653) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: ME MD29371) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OK 34684) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 104313) | |
| Enumeration Date | 2018-04-10 |
| Last Update Date | 2025-09-19 |