| NPI | 1518196377 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: IL 036.134579) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IL 125-055910) |
| Enumeration Date | 2009-07-14 |
| Last Update Date | 2021-11-19 |