| NPI | 1346019841 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 656490) |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic |
| 156F00000X Technician/Technologist | |
| Enumeration Date | 2023-12-26 |
| Last Update Date | 2023-12-26 |