NPI | 1841583051 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: FL ME164990) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MT199689) |
2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME128516) | |
390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT199689) | |
Enumeration Date | 2011-05-20 |
Last Update Date | 2024-10-14 |