| NPI | 1770052268 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 246ZE0600X Specialist/Technologist, Other, Electroneurodiagnostic |
| Additional Taxonomies | 374700000X Technician |
| 2471M1202X Radiologic Technologist, Magnetic Resonance Imaging | |
| Enumeration Date | 2018-11-14 |
| Last Update Date | 2018-11-14 |