| NPI | 1982067294 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A171252) |
| Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: OH 35.134129) |
| 2085B0100X Radiology, Body Imaging (Licence: CA A171252) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35.134129) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-04-04 |
| Last Update Date | 2022-10-17 |