| NPI | 1184460677 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 243U00000X Radiology Practitioner Assistant (Licence: FL RA165) |
| Additional Taxonomies | 2471V0106X Radiologic Technologist, Vascular-Interventional Technology (Licence: FL CRT39545) |
| Enumeration Date | 2024-07-03 |
| Last Update Date | 2024-07-03 |