| NPI | 1497946115 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2471C1101X Radiologic Technologist, Cardiovascular-Interventional Technology (Licence: CA C41052) |
| Additional Taxonomies | 247100000X Radiologic Technologist (Licence: CA C41052) |
| 2471C3402X Radiologic Technologist, Radiography | |
| 2471N0900X Radiologic Technologist, Nuclear Medicine Technology | |
| Enumeration Date | 2007-08-07 |
| Last Update Date | 2007-08-07 |