| NPI | 1346434479 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 335V00000X Portable X-Ray and/or Other Portable Diagnostic Imaging Supplier (Licence: TX R31570) |
| Additional Taxonomies | 2471S1302X Radiologic Technologist, Sonography (Licence: TX 12981) |
| Enumeration Date | 2007-08-31 |
| Last Update Date | 2014-11-10 |