| NPI | 1538180203 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 247100000X Radiologic Technologist (Licence: 190481) |
| Additional Taxonomies | 2471N0900X Radiologic Technologist Nuclear Medicine Technology (Licence: 190481) |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2007-07-08 |