| NPI | 1699650036 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 243U00000X Radiology Practitioner Assistant (Licence: OH 68.000029) |
| Additional Taxonomies | 247100000X Radiologic Technologist (Licence: OH 427776) |
| Enumeration Date | 2025-08-06 |
| Last Update Date | 2025-08-06 |