| NPI | 1861881716 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 04-49188) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: AR E-16195) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 31237) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-01-15 |
| Last Update Date | 2024-07-01 |