NPI | 1053707521 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: FL 145483) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2015-04-12 |
Last Update Date | 2020-09-22 |