NPI | 1235301714 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: CA A111934) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
2085R0001X Radiology, Radiation Oncology (Licence: FL ME102606) | |
Enumeration Date | 2008-03-25 |
Last Update Date | 2011-05-24 |