| NPI | 1891765806 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AK 7551) |
| Additional Taxonomies | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: IN 01062532A) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2006-01-23 |
| Last Update Date | 2023-09-19 |