| NPI | 1891211215 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: OK 33731) |
| 207U00000X Nuclear Medicine (Licence: OK 33731) | |
| Enumeration Date | 2017-08-17 |
| Last Update Date | 2024-05-19 |