| NPI | 1841728219 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0203X Radiology, Therapeutic Radiology (Licence: NY 317318-01) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MA 271977) | |
| Enumeration Date | 2017-05-31 |
| Last Update Date | 2023-02-28 |