| NPI | 1922461862 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A152893) |
| Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: CA A152) |
| 2085H0002X Radiology, Hospice and Palliative Medicine (Licence: CA A152893) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CA A152893) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-03-29 |
| Last Update Date | 2021-07-19 |