| NPI | 1700116944 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2471C3402X Radiologic Technologist, Radiography (Licence: TX 97853) |
| Additional Taxonomies | 247100000X Radiologic Technologist (Licence: TX 97853) |
| Enumeration Date | 2010-01-11 |
| Last Update Date | 2010-01-11 |