| NPI | 1821101783 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2471M1202X Radiologic Technologist, Magnetic Resonance Imaging (Licence: 340833) |
| Additional Taxonomies | 247100000X Radiologic Technologist (Licence: 340833) |
| 2471C3402X Radiologic Technologist, Radiography (Licence: 340833) | |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2025-09-11 |