| NPI | 1144429721 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 247100000X Radiologic Technologist (Licence: NY 280816) |
| Additional Taxonomies | 247100000X Radiologic Technologist (Licence: NY 470840) |
| Enumeration Date | 2007-07-13 |
| Last Update Date | 2007-07-13 |