| NPI | 1548291354 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 243U00000X Radiology Practitioner Assistant (Licence: MS RA00005) |
| Additional Taxonomies | 243U00000X Radiology Practitioner Assistant (Licence: MA 09125) |
| 2471V0106X Radiologic Technologist, Vascular-Interventional Technology (Licence: MA 09125) | |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2025-01-29 |