NPI | 1710120217 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 247100000X Radiologic Technologist (Licence: PR 2194) |
Additional Taxonomies | 2471R0002X Radiologic Technologist, Radiation Therapy (Licence: PR #87) |
Enumeration Date | 2009-04-13 |
Last Update Date | 2009-04-13 |