| NPI | 1457072480 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2471M1202X Radiologic Technologist Magnetic Resonance Imaging (Licence: CA 2399) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA 34150) |
| Enumeration Date | 2022-09-08 |
| Last Update Date | 2022-09-08 |