| NPI | 1720278336 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 243U00000X Radiology Practitioner Assistant (Licence: MA 14482) |
| Additional Taxonomies | 2471C1101X Radiologic Technologist, Cardiovascular-Interventional Technology (Licence: MA 14482) |
| Enumeration Date | 2007-07-30 |
| Last Update Date | 2008-10-14 |