| NPI | 1982928990 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085D0003X Radiology, Diagnostic Neuroimaging (Licence: LA MD.204704) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2010-03-19 |
| Last Update Date | 2016-01-28 |