| NPI | 1932661154 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 008762) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: UT 13818928-1204) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: ID O-1994) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-04-05 |
| Last Update Date | 2024-06-13 |