NPI | 1811375082 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 30932) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 125.067240) |
208D00000X General Practice (Licence: IL 125.067240) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2015-05-08 |
Last Update Date | 2022-06-03 |