| NPI | 1821279845 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: LA 205344) |
| Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: AL 28838) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2007-11-19 |
| Last Update Date | 2018-03-19 |