| NPI | 1174143713 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2471S1302X Radiologic Technologist Sonography |
| Additional Taxonomies | 2471V0106X Radiologic Technologist Vascular-Interventional Technology |
| Enumeration Date | 2020-04-23 |
| Last Update Date | 2020-04-23 |