| NPI | 1033550579 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2471V0105X Radiologic Technologist, Vascular Sonography |
| Additional Taxonomies | 246XS1301X Spec/Tech, Cardiovascular, Sonography |
| Enumeration Date | 2013-07-12 |
| Last Update Date | 2013-07-12 |