| NPI | 1952732000 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 243U00000X Radiology Practitioner Assistant (Licence: UT 09nm1012) |
| Additional Taxonomies | 247100000X Radiologic Technologist (Licence: NM 161279) |
| Enumeration Date | 2013-11-27 |
| Last Update Date | 2013-11-27 |