| NPI | 1043588833 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2471C3401X Radiologic Technologist, Computed Tomography (Licence: CA RHF64081) |
| Additional Taxonomies | 2471C3401X Radiologic Technologist, Computed Tomography (Licence: AZ CRT-12657) |
| 2471C3401X Radiologic Technologist, Computed Tomography (Licence: WA RT60090679) | |
| Enumeration Date | 2011-12-07 |
| Last Update Date | 2011-12-07 |