| NPI | 1336402874 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: NE 30001) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: CO DR.0069907) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 0116024816) | |
| 2085R0001X Radiology, Radiation Oncology (Licence: NE 7007) | |
| Enumeration Date | 2012-06-20 |
| Last Update Date | 2022-12-21 |