| NPI | 1124714449 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2471S1302X Radiologic Technologist Sonography |
| Additional Taxonomies | 2471C3402X Radiologic Technologist Radiography |
| 2471V0105X Radiologic Technologist Vascular Sonography | |
| Enumeration Date | 2023-04-12 |
| Last Update Date | 2023-04-12 |