| NPI | 1972931921 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2471C1106X Radiologic Technologist, Cardiac-Interventional Technology (Licence: IL 500501702) |
| Additional Taxonomies | 2471C1106X Radiologic Technologist, Cardiac-Interventional Technology (Licence: CA RHF00097620) |
| 2471C1106X Radiologic Technologist, Cardiac-Interventional Technology (Licence: SC 00-6456) | |
| Enumeration Date | 2013-10-29 |
| Last Update Date | 2013-10-29 |