| NPI | 1932583804 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NC 2022-00503) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: SC 87219) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL TRN21721) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: VA 0101274007) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-07-10 |
| Last Update Date | 2025-10-01 |