| NPI | 1932316098 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME131614) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2008-01871) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NV 13436) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 0116017014) | |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2022-07-21 |