| NPI | 1134508039 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2471M1202X Radiologic Technologist Magnetic Resonance Imaging (Licence: CA 180139) |
| Additional Taxonomies | 2471M1202X Radiologic Technologist Magnetic Resonance Imaging (Licence: CA RHT00045134) |
| Enumeration Date | 2015-05-25 |
| Last Update Date | 2015-05-25 |