| NPI | 1386978666 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 247100000X Radiologic Technologist (Licence: AR RT5301) |
| Additional Taxonomies | 2471B0102X Radiologic Technologist, Bone Densitometry (Licence: AR RT5301) |
| Enumeration Date | 2009-09-20 |
| Last Update Date | 2009-09-20 |