| NPI | 1861711624 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 075642) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IN 11015439A) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101258195) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01071444A) | |
| Enumeration Date | 2010-05-19 |
| Last Update Date | 2016-08-08 |