| NPI | 1336883917 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 247100000X Radiologic Technologist (Licence: CA RHF00108634) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA RHF00108634) |
| Enumeration Date | 2022-04-21 |
| Last Update Date | 2022-04-21 |