| NPI | 1801567698 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2471M1202X Radiologic Technologist, Magnetic Resonance Imaging (Licence: FL CRT69752) |
| Additional Taxonomies | 247100000X Radiologic Technologist (Licence: FL 465406) |
| 2471N0900X Radiologic Technologist, Nuclear Medicine Technology (Licence: FL 032575) | |
| Enumeration Date | 2021-09-22 |
| Last Update Date | 2021-09-22 |