| NPI | 1154528982 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 243U00000X Radiology Practitioner Assistant (Licence: UT 02 TN 1039) |
| Additional Taxonomies | 2471C3402X Radiologic Technologist, Radiography (Licence: GA 231751) |
| Enumeration Date | 2007-06-27 |
| Last Update Date | 2016-11-30 |