NPI | 1972708345 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: SC 83457) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101244742) |
390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 0116019717) | |
Enumeration Date | 2007-06-18 |
Last Update Date | 2022-12-07 |