| NPI | 1093332421 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 246XS1301X Spec/Tech, Cardiovascular, Sonography (Licence: MO 013648) |
| Additional Taxonomies | 2471V0105X Radiologic Technologist, Vascular Sonography (Licence: MO 013648) |
| Enumeration Date | 2020-07-01 |
| Last Update Date | 2020-07-01 |