| NPI | 1093894909 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 246XS1301X Specialist/Technologist Cardiovascular Sonography |
| Additional Taxonomies | 2471S1302X Radiologic Technologist Sonography |
| 2471V0105X Radiologic Technologist Vascular Sonography | |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2007-07-08 |