| NPI | 1740685825 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2471C3401X Radiologic Technologist Computed Tomography |
| Additional Taxonomies | 247100000X Radiologic Technologist |
| Enumeration Date | 2014-10-30 |
| Last Update Date | 2014-10-30 |