| NPI | 1699654061 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 247100000X Radiologic Technologist (Licence: NV PL03791) |
| Additional Taxonomies | 2471C3401X Radiologic Technologist, Computed Tomography (Licence: NV PL03791) |
| 2471C3402X Radiologic Technologist, Radiography (Licence: NV PL03791) | |
| Enumeration Date | 2025-08-29 |
| Last Update Date | 2025-08-29 |