| NPI | 1942643507 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2471M1202X Radiologic Technologist, Magnetic Resonance Imaging (Licence: OK 271305) |
| Additional Taxonomies | 247100000X Radiologic Technologist (Licence: OK 271305) |
| 2471C3402X Radiologic Technologist, Radiography (Licence: OK 271305) | |
| Enumeration Date | 2013-04-14 |
| Last Update Date | 2013-04-14 |