NPI | 1912683186 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: MO 2024022436) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MO 2023022978) |
Enumeration Date | 2023-06-23 |
Last Update Date | 2024-07-29 |