| NPI | 1174964787 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: OH 35.126872) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57.023062) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-07-11 |
| Last Update Date | 2024-06-05 |