| NPI | 1902580582 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207U00000X Nuclear Medicine (Licence: WI 100656-851) | 
| Additional Taxonomies | 2085N0904X (Licence: WI 100656-851) | 
| Enumeration Date | 2023-06-14 | 
| Last Update Date | 2024-06-28 |