NPI | 1780836528 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101251267) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
2085R0204X Radiology, Vascular & Interventional Radiology (Licence: VA 0101251267) | |
Enumeration Date | 2008-10-10 |
Last Update Date | 2012-08-16 |