NPI | 1780138289 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A172470) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
2085R0202X Radiology, Diagnostic Radiology (Licence: MD D84949) | |
Enumeration Date | 2016-08-12 |
Last Update Date | 2021-08-23 |