NPI | 1982137816 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME148604) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
2085R0202X Radiology, Diagnostic Radiology (Licence: GA 98539) | |
2085R0202X Radiology, Diagnostic Radiology (Licence: TN 64928) | |
Enumeration Date | 2017-04-07 |
Last Update Date | 2025-09-19 |