| NPI | 1699083303 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 247100000X Radiologic Technologist (Licence: CA RHF92060) |
| Additional Taxonomies | 247100000X Radiologic Technologist (Licence: CA RHT92060) |
| Enumeration Date | 2010-09-15 |
| Last Update Date | 2010-09-15 |