| NPI | 1710339882 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: WA 1710339882) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY 082N FM4293748) |
| Enumeration Date | 2016-07-12 |
| Last Update Date | 2023-05-17 |