| NPI | 1801510680 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 243U00000X Radiology Practitioner Assistant (Licence: GA 23RRAGA0213) |
| Additional Taxonomies | 2471V0106X Radiologic Technologist, Vascular-Interventional Technology (Licence: ND 581533) |
| Enumeration Date | 2022-09-27 |
| Last Update Date | 2023-03-29 |