| NPI | 1164945309 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207UN0902X Nuclear Medicine, Nuclear Imaging & Therapy (Licence: PA MD478974) |
| Additional Taxonomies | 2085N0904X Radiology, Nuclear Radiology (Licence: NY 320026) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-07-19 |
| Last Update Date | 2024-01-23 |