| NPI | 1861128035 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 247000000X Technician, Health Information |
| Additional Taxonomies | 247000000X Technician, Health Information |
| Enumeration Date | 2022-07-28 |
| Last Update Date | 2024-07-11 |