| NPI | 1336476514 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2471C3402X Radiologic Technologist, Radiography (Licence: TX 23364) |
| Additional Taxonomies | 2471C3402X Radiologic Technologist, Radiography (Licence: WA RT 00007061) |
| 2471C3402X Radiologic Technologist, Radiography (Licence: CA RHF 96247) | |
| 2471C3402X Radiologic Technologist, Radiography (Licence: HI R-3058) | |
| Enumeration Date | 2009-11-10 |
| Last Update Date | 2009-11-10 |