| NPI | 1194227504 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207U00000X Nuclear Medicine (Licence: FL ME156921) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: WI 74006-20) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-03-01 |
| Last Update Date | 2023-04-19 |