NPI | 1396344859 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2471C3402X Radiologic Technologist Radiography (Licence: VA 510394) |
Additional Taxonomies | 2471C3401X Radiologic Technologist Computed Tomography (Licence: VA 510394) |
2471M1202X Radiologic Technologist Magnetic Resonance Imaging (Licence: VA 510394) | |
335V00000X Portable X-ray and/or Other Portable Diagnostic Imaging Supplier (Licence: VA 510394) | |
Enumeration Date | 2020-10-25 |
Last Update Date | 2020-10-25 |