| NPI | 1821482381 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NV 21453) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A146456) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NM TM2021-0829) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-03-23 |
| Last Update Date | 2023-10-03 |