NPI | 1811330954 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2020020776) |
Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: CA 161916) |
2085R0202X Radiology, Diagnostic Radiology (Licence: KS 0443996) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2013-04-08 |
Last Update Date | 2023-02-02 |