| NPI | 1326290446 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 243U00000X Radiology Practitioner Assistant (Licence: 05F1175) |
| Additional Taxonomies | 247100000X Radiologic Technologist (Licence: 234273) |
| 2471C3401X Radiologic Technologist, Computed Tomography (Licence: 234273) | |
| 2471M1202X Radiologic Technologist, Magnetic Resonance Imaging (Licence: 234273) | |
| Enumeration Date | 2008-10-21 |
| Last Update Date | 2008-10-21 |