| NPI | 1952589202 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A103380) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO DR.0060300) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-02-07 |
| Last Update Date | 2024-01-03 |