| NPI | 1144650516 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 247100000X Radiologic Technologist (Licence: TN 526609) |
| Additional Taxonomies | 247100000X Radiologic Technologist (Licence: MN 337987) |
| 2471N0900X Radiologic Technologist, Nuclear Medicine Technology (Licence: GA 037775) | |
| Enumeration Date | 2013-11-20 |
| Last Update Date | 2013-11-20 |