| NPI | 1750060513 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207U00000X Nuclear Medicine (Licence: GA 100734) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: GA 100734) |
| Enumeration Date | 2023-07-17 |
| Last Update Date | 2024-12-17 |