| NPI | 1831687664 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2471M1202X Radiologic Technologist, Magnetic Resonance Imaging (Licence: FL 535823) |
| Additional Taxonomies | 247100000X Radiologic Technologist (Licence: FL 535823) |
| 2471C3401X Radiologic Technologist, Computed Tomography (Licence: FL 535823) | |
| Enumeration Date | 2018-04-26 |
| Last Update Date | 2018-04-26 |