| NPI | 1336247428 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2471C3402X Radiologic Technologist, Radiography |
| Additional Taxonomies | 2471S1302X Radiologic Technologist, Sonography |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2007-12-06 |