| NPI | 1427443852 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207U00000X Nuclear Medicine (Licence: GA 81901) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 081901) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-04-02 |
| Last Update Date | 2026-07-06 |