| NPI | 1730585712 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 247100000X Radiologic Technologist |
| Additional Taxonomies | 2471C3401X Radiologic Technologist, Computed Tomography |
| 2471C3402X Radiologic Technologist, Radiography | |
| 2471M1202X Radiologic Technologist, Magnetic Resonance Imaging | |
| Enumeration Date | 2014-11-18 |
| Last Update Date | 2014-11-18 |