NPI | 1356608434 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: VA 0101262013) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2012-04-13 |
Last Update Date | 2020-10-28 |