NPI | 1316490931 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 246XS1301X Spec/Tech, Cardiovascular, Sonography (Licence: MD 42861) |
Additional Taxonomies | 2471S1302X Radiologic Technologist, Sonography (Licence: MD 42861) |
2471V0105X Radiologic Technologist, Vascular Sonography (Licence: MD 42861) | |
Enumeration Date | 2016-07-31 |
Last Update Date | 2016-07-31 |