| NPI | 1144587445 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2471C1101X Radiologic Technologist, Cardiovascular-Interventional Technology |
| Additional Taxonomies | 246XS1301X Spec/Tech, Cardiovascular, Sonography |
| 2471V0106X Radiologic Technologist, Vascular-Interventional Technology | |
| Enumeration Date | 2012-04-12 |
| Last Update Date | 2012-04-12 |