NPI | 1588870323 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: OH 35.097860) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT188837) |
Enumeration Date | 2007-05-16 |
Last Update Date | 2011-08-30 |