| NPI | 1730341348 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2471C3401X Radiologic Technologist Computed Tomography (Licence: AZ CRT 11564) |
| Additional Taxonomies | 247100000X Radiologic Technologist (Licence: AZ CRT 11564) |
| 2471M1202X Radiologic Technologist Magnetic Resonance Imaging (Licence: AZ CRT 11564) | |
| Enumeration Date | 2008-06-26 |
| Last Update Date | 2008-06-26 |