NPI | 1356505291 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: VA 0101256304) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 0116022444) | |
Enumeration Date | 2008-07-10 |
Last Update Date | 2014-12-01 |