NPI | 1841780699 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX U9961) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 239422) |
Enumeration Date | 2018-05-17 |
Last Update Date | 2024-07-11 |