| NPI | 1871072041 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2471C3401X Radiologic Technologist, Computed Tomography |
| Additional Taxonomies | 2471M1202X Radiologic Technologist, Magnetic Resonance Imaging |
| Enumeration Date | 2018-08-08 |
| Last Update Date | 2018-08-08 |