| NPI | 1891016150 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX P8920) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: LA 301210) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101257942) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-06-21 |
| Last Update Date | 2022-09-26 |