| NPI | 1174793202 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2471S1302X Radiologic Technologist, Sonography |
| Additional Taxonomies | 247100000X Radiologic Technologist (Licence: FL CRT74089) |
| 247100000X Radiologic Technologist (Licence: MS MRT2046) | |
| Enumeration Date | 2008-03-05 |
| Last Update Date | 2008-03-05 |