| NPI | 1114181815 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 243U00000X Radiology Practitioner Assistant |
| Additional Taxonomies | 2471C1101X Radiologic Technologist, Cardiovascular-Interventional Technology |
| Enumeration Date | 2008-07-11 |
| Last Update Date | 2019-10-25 |