| NPI | 1881984425 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME173444) | 
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01084884A) | 
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-04-16 | 
| Last Update Date | 2025-07-02 |