| NPI | 1568586196 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 247100000X Radiologic Technologist (Licence: AR RT1380) |
| Additional Taxonomies | 2471M1202X Radiologic Technologist, Magnetic Resonance Imaging (Licence: 290764) |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2007-07-08 |