| NPI | 1992967814 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 243U00000X Radiology Practitioner Assistant (Licence: MT 2331) |
| Additional Taxonomies | 247100000X Radiologic Technologist (Licence: MT 2331) |
| Enumeration Date | 2008-07-01 |
| Last Update Date | 2008-09-29 |