| NPI | 1922497387 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2471C3401X Radiologic Technologist, Computed Tomography (Licence: MS MRT1712) |
| Additional Taxonomies | 247100000X Radiologic Technologist (Licence: MS MRT1712) |
| Enumeration Date | 2015-01-22 |
| Last Update Date | 2015-01-22 |