| NPI | 1578863452 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 247100000X Radiologic Technologist (Licence: CA RHF00071304) |
| Additional Taxonomies | 247100000X Radiologic Technologist (Licence: CA RHF00098645) |
| 247100000X Radiologic Technologist (Licence: CA RHF00089936) | |
| 247100000X Radiologic Technologist (Licence: CA RHF00070286) | |
| Enumeration Date | 2010-10-26 |
| Last Update Date | 2013-08-12 |