| NPI | 1497993943 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 243U00000X Radiology Practitioner Assistant (Licence: CO 04CO1111) |
| Additional Taxonomies | 2471C3401X Radiologic Technologist Computed Tomography (Licence: CO 194525) |
| 2471C3402X Radiologic Technologist Radiography (Licence: CO 194525) | |
| 2471Q0001X Radiologic Technologist Quality Management (Licence: CO 194525) | |
| 2471B0102X Radiologic Technologist Bone Densitometry (Licence: CO 194525) | |
| Enumeration Date | 2009-01-21 |
| Last Update Date | 2011-08-09 |