| NPI | 1497164388 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2471M1202X Radiologic Technologist, Magnetic Resonance Imaging (Licence: 16286) |
| Additional Taxonomies | 247100000X Radiologic Technologist (Licence: AZ 16286) |
| 2471C3401X Radiologic Technologist, Computed Tomography (Licence: AZ 16286) | |
| Enumeration Date | 2014-08-05 |
| Last Update Date | 2014-08-05 |