| NPI | 1265796114 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2471S1302X Radiologic Technologist, Sonography (Licence: TN 112229) |
| Additional Taxonomies | 247100000X Radiologic Technologist (Licence: TN 346808) |
| 2471V0105X Radiologic Technologist, Vascular Sonography (Licence: TN 112229) | |
| Enumeration Date | 2012-06-26 |
| Last Update Date | 2012-07-10 |