| NPI | 1831509330 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: AR E-12301) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: TX BP10052146) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT206454) | |
| Enumeration Date | 2014-05-06 |
| Last Update Date | 2019-06-07 |