| NPI | 1013545912 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207U00000X Nuclear Medicine (Licence: GA 100733) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: FL ME180633) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-03-28 |
| Last Update Date | 2026-06-03 |