| NPI | 1376684407 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2471C3402X Radiologic Technologist Radiography (Licence: TN 119244) |
| Additional Taxonomies | 2471S1302X Radiologic Technologist Sonography (Licence: TN 6350) |
| Enumeration Date | 2007-02-10 |
| Last Update Date | 2007-07-08 |