| NPI | 1205516937 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085U0001X Radiology, Diagnostic Ultrasound (Licence: CA 102917) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CA 102917) |
| 2471S1302X Radiologic Technologist, Sonography (Licence: CA 102917) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CA 102917) | |
| 2471V0105X Radiologic Technologist, Vascular Sonography (Licence: CA 102917) | |
| 2471V0106X Radiologic Technologist, Vascular-Interventional Technology (Licence: CA 102917) | |
| Enumeration Date | 2023-07-18 |
| Last Update Date | 2023-07-18 |