| NPI | 1760527766 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2471C3402X Radiologic Technologist, Radiography (Licence: 354922) |
| Additional Taxonomies | 2471M1202X Radiologic Technologist, Magnetic Resonance Imaging (Licence: 354922) |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2007-07-08 |