| NPI | 1376153536 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207UN0902X Nuclear Medicine, Nuclear Imaging & Therapy (Licence: PR 23813) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PR 6189936) |
| Enumeration Date | 2020-08-03 |
| Last Update Date | 2025-03-25 |