| NPI | 1932306735 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2471C3402X Radiologic Technologist, Radiography (Licence: MA 06481) |
| Additional Taxonomies | 243U00000X Radiology Practitioner Assistant (Licence: MA 06481) |
| Enumeration Date | 2007-06-27 |
| Last Update Date | 2008-09-29 |