| NPI | 1184155814 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: NY 320186) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: WA MD61271931) |
| 2085R0001X Radiology, Radiation Oncology (Licence: CA A179311) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-03-24 |
| Last Update Date | 2022-12-30 |