| NPI | 1427628296 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2471C3401X Radiologic Technologist, Computed Tomography (Licence: OH 525400) |
| Additional Taxonomies | 2471C3402X Radiologic Technologist, Radiography (Licence: OH 525400) |
| Enumeration Date | 2021-06-24 |
| Last Update Date | 2021-06-24 |