| NPI | 1194145532 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: AR E-14474) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: KS 0442072) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-04-24 |
| Last Update Date | 2022-04-05 |