| NPI | 1265935027 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: CA A192194) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: CO DR.0070332) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-03-17 |
| Last Update Date | 2023-12-11 |