| NPI | 1194287482 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: AR E-17824) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: WI 76075) |
| 208D00000X General Practice (Licence: WI 76075) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-04-04 |
| Last Update Date | 2024-08-05 |