| NPI | 1871750729 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: NE 27785) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: MO 2017022191) |
| 207R00000X Internal Medicine (Licence: KS 6929) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: HI MD17638) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: KS 04-34841) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: CO 53434) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: AZ 47210) | |
| Enumeration Date | 2008-05-19 |
| Last Update Date | 2020-06-02 |