| NPI | 1831576008 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: NH 20227) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: NH 2992) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: VT 042.0014655) | |
| Enumeration Date | 2015-04-27 |
| Last Update Date | 2020-05-26 |