NPI | 1528487089 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0001X Radiology Radiation Oncology (Licence: NJ 25MA10129400) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2014-04-14 |
Last Update Date | 2019-05-09 |