NPI | 1770216798 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CT 77750) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 328880) |
390200000X Student in an Organized Health Care Education/Training Program (Licence: NY P105276) | |
Enumeration Date | 2022-07-07 |
Last Update Date | 2024-05-29 |