| NPI | 1780048314 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0205X Radiology, Radiological Physics (Licence: NC 060-0019-6) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2016-04-10 |
| Last Update Date | 2024-05-24 |