| NPI | 1770087850 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: VA 0101281315) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY 64033) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101281315) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-03-22 |
| Last Update Date | 2024-06-03 |