| NPI | 1235235110 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 246XS1301X Specialist/Technologist Cardiovascular Sonography |
| Additional Taxonomies | 2471V0105X Radiologic Technologist Vascular Sonography |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2007-07-09 |