NPI | 1417310046 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: UT 12250382-1205) |
Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: WY 13723A) |
2085R0001X Radiology, Radiation Oncology (Licence: ID M-15792) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2016-03-31 |
Last Update Date | 2022-02-16 |