| NPI | 1003226861 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: TX U5436) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: CA A162357) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-05-02 |
| Last Update Date | 2023-08-15 |