| NPI | 1629369830 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: ND 13647) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: MN 105542) |
| 2085R0001X Radiology, Radiation Oncology (Licence: MN 54356) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-04-21 |
| Last Update Date | 2022-03-25 |