| NPI | 1235277468 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 243U00000X Radiology Practitioner Assistant (Licence: CO 07 CO 1296) |
| Additional Taxonomies | 247100000X Radiologic Technologist (Licence: CO 327973) |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2023-02-08 |