| NPI | 1578745576 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2471C3402X Radiologic Technologist, Radiography |
| Additional Taxonomies | 2471S1302X Radiologic Technologist, Sonography |
| Enumeration Date | 2007-11-30 |
| Last Update Date | 2016-09-17 |