| NPI | 1568691830 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: CA A159761) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: WA MD60242361) |
| 2471R0002X Radiologic Technologist, Radiation Therapy | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MA 241530) | |
| Enumeration Date | 2009-07-08 |
| Last Update Date | 2023-07-31 |