| NPI | 1922730803 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2471C3402X Radiologic Technologist, Radiography (Licence: OR 917283) |
| Additional Taxonomies | 247100000X Radiologic Technologist (Licence: WA 60899550) |
| Enumeration Date | 2022-06-28 |
| Last Update Date | 2022-06-28 |