| NPI | 1790244697 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036.162156) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL OS20664) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TX U6515) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-03-19 |
| Last Update Date | 2024-12-27 |