| NPI | 1306121108 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2471V0105X Radiologic Technologist, Vascular Sonography (Licence: MD 92430) |
| Additional Taxonomies | 246ZE0600X Specialist/Technologist, Other, Electroneurodiagnostic |
| 247100000X Radiologic Technologist | |
| 2471C3401X Radiologic Technologist, Computed Tomography | |
| 2471V0106X Radiologic Technologist, Vascular-Interventional Technology | |
| 2472E0500X | |
| 2471S1302X Radiologic Technologist, Sonography (Licence: MD 92430) | |
| 246XS1301X Spec/Tech, Cardiovascular, Sonography (Licence: MD 92430) | |
| 2471C3402X Radiologic Technologist, Radiography (Licence: MN 283752) | |
| 246Z00000X Specialist/Technologist, Other | |
| Enumeration Date | 2011-10-13 |
| Last Update Date | 2016-09-07 |