| NPI | 1851666044 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: NY 286994-1) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 286994-1) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-03-20 |
| Last Update Date | 2024-01-18 |