| NPI | 1871470419 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 247100000X Radiologic Technologist (Licence: HI 432278) |
| Additional Taxonomies | 2471C3402X Radiologic Technologist, Radiography (Licence: HI R6940) |
| Enumeration Date | 2025-08-18 |
| Last Update Date | 2025-08-18 |