| NPI | 1184184160 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: NH 25062) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: MA 1017867) |
| 208D00000X General Practice (Licence: CA A180474) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-03-25 |
| Last Update Date | 2024-07-09 |