| NPI | 1154089100 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 243U00000X Radiology Practitioner Assistant |
| Additional Taxonomies | 247100000X Radiologic Technologist (Licence: FL CRT79064) |
| Enumeration Date | 2021-12-07 |
| Last Update Date | 2023-09-06 |