| NPI | 1710188065 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: CA C168649) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: IL 036119253) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: OR LL16228) | |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2020-09-09 |