| NPI | 1982818373 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: MA 1015001) |
| Additional Taxonomies | 2085N0904X Radiology Nuclear Radiology (Licence: MA 1015001) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: NY 238696) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2023-06-29 |