| NPI | 1093142390 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2471S1302X Radiologic Technologist, Sonography (Licence: TX 149604) |
| Additional Taxonomies | 2471V0105X Radiologic Technologist, Vascular Sonography (Licence: TX 149604) |
| Enumeration Date | 2013-10-01 |
| Last Update Date | 2013-10-01 |