| NPI | 1407509789 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2471C3402X Radiologic Technologist, Radiography (Licence: FL CRT95545) |
| Additional Taxonomies | 247100000X Radiologic Technologist (Licence: FL 95545) |
| Enumeration Date | 2022-01-27 |
| Last Update Date | 2022-03-18 |