| NPI | 1932441029 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 297103) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT204258) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 258147) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-03-26 |
| Last Update Date | 2021-05-21 |