| NPI | 1326296294 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2471C3402X Radiologic Technologist, Radiography (Licence: NC 406071) |
| Additional Taxonomies | 2471C3402X Radiologic Technologist, Radiography |
| Enumeration Date | 2008-09-04 |
| Last Update Date | 2010-10-13 |