| NPI | 1043823537 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 246XS1301X Specialist/Technologist Cardiovascular Sonography |
| Additional Taxonomies | 2085U0001X Radiology Diagnostic Ultrasound (Licence: TX 152378) |
| Enumeration Date | 2020-08-25 |
| Last Update Date | 2020-08-25 |