| NPI | 1922762079 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2471C3401X Radiologic Technologist, Computed Tomography |
| Additional Taxonomies | 2471C3402X Radiologic Technologist, Radiography |
| Enumeration Date | 2021-10-25 |
| Last Update Date | 2021-10-25 |