| NPI | 1164651642 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2471S1302X Radiologic Technologist Sonography |
| Additional Taxonomies | 246XS1301X Specialist/Technologist Cardiovascular Sonography |
| 2471V0105X Radiologic Technologist Vascular Sonography | |
| Enumeration Date | 2009-07-06 |
| Last Update Date | 2011-08-19 |