| NPI | 1598125320 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2471C3401X Radiologic Technologist, Computed Tomography (Licence: SC 467850) |
| Additional Taxonomies | 2471C3402X Radiologic Technologist, Radiography (Licence: SC 467850) |
| Enumeration Date | 2016-03-07 |
| Last Update Date | 2016-03-07 |