| NPI | 1922718634 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835N0905X Pharmacist, Nuclear (Licence: TX 57264) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TX 57264) |
| 2471N0900X Radiologic Technologist, Nuclear Medicine Technology (Licence: 451609) | |
| Enumeration Date | 2022-12-05 |
| Last Update Date | 2024-01-08 |