| NPI | 1467657155 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2471C1101X Radiologic Technologist Cardiovascular-Interventional Technology (Licence: 00052044) |
| Additional Taxonomies | 2471C3402X Radiologic Technologist Radiography (Licence: 305674) |
| 2471C3402X Radiologic Technologist Radiography (Licence: TX 26514) | |
| 2471C3402X Radiologic Technologist Radiography (Licence: FL CRT-72638) | |
| Enumeration Date | 2007-06-20 |
| Last Update Date | 2007-07-08 |