| NPI | 1245427988 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 243U00000X Radiology Practitioner Assistant (Licence: WY 07WY1329) |
| Additional Taxonomies | 247100000X Radiologic Technologist (Licence: 203832) |
| Enumeration Date | 2007-09-26 |
| Last Update Date | 2008-11-19 |