| NPI | 1750267605 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0205X Radiology, Radiological Physics (Licence: CA G36245) |
| Additional Taxonomies | 2471S1302X Radiologic Technologist, Sonography |
| 2471V0105X Radiologic Technologist, Vascular Sonography | |
| 247200000X Technician, Other | |
| Enumeration Date | 2025-08-14 |
| Last Update Date | 2025-12-29 |