| NPI | 1740973866 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 243U00000X Radiology Practitioner Assistant (Licence: CA 21CA0919) |
| Additional Taxonomies | 2471C3402X Radiologic Technologist Radiography (Licence: CA 574424) |
| Enumeration Date | 2023-06-02 |
| Last Update Date | 2023-06-02 |