| NPI | 1023351673 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology Radiation Oncology (Licence: IL 036154868) |
| Additional Taxonomies | 2085R0001X Radiology Radiation Oncology (Licence: GA 80454) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-04-02 |
| Last Update Date | 2021-09-16 |