| NPI | 1932531829 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2471R0002X Radiologic Technologist, Radiation Therapy (Licence: AZ CTT-1099) |
| Additional Taxonomies | 2471R0002X Radiologic Technologist, Radiation Therapy (Licence: CA RHT00101374) |
| 2471R0002X Radiologic Technologist, Radiation Therapy (Licence: OH 8867519) | |
| 2471R0002X Radiologic Technologist, Radiation Therapy (Licence: OR 206215) | |
| 2471R0002X Radiologic Technologist, Radiation Therapy (Licence: WA RT 00008408) | |
| Enumeration Date | 2013-08-02 |
| Last Update Date | 2013-08-02 |