| NPI | 1720443559 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 243U00000X Radiology Practitioner Assistant (Licence: NC 04nc1095) |
| Additional Taxonomies | 2471C3402X Radiologic Technologist, Radiography (Licence: 304401) |
| Enumeration Date | 2015-12-21 |
| Last Update Date | 2015-12-22 |