| NPI | 1033230768 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207U00000X Nuclear Medicine (Licence: MI 4301087332) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301087332) |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2026-02-04 |