NPI | 1114473097 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0001X Radiology Radiation Oncology (Licence: PR 021264) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT214392) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2016-08-30 |
Last Update Date | 2021-11-11 |