NPI | 1851658116 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: GA 102772) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D0088054) |
2085R0202X Radiology, Diagnostic Radiology (Licence: DC MD045984) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2012-04-11 |
Last Update Date | 2025-07-29 |