| NPI | 1679974026 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2471C3401X Radiologic Technologist, Computed Tomography (Licence: GA 441602) |
| Additional Taxonomies | 247100000X Radiologic Technologist (Licence: GA 441602) |
| 2471C3402X Radiologic Technologist, Radiography (Licence: GA 441602) | |
| Enumeration Date | 2014-09-04 |
| Last Update Date | 2014-09-04 |