| NPI | 1538325535 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 247100000X Radiologic Technologist (Licence: NY 398678) |
| Additional Taxonomies | 247100000X Radiologic Technologist (Licence: CT 005359) |
| Enumeration Date | 2008-07-30 |
| Last Update Date | 2008-07-30 |