| NPI | 1396432456 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 246X00000X Spec/Tech, Cardiovascular (Licence: CA 136434) |
| Additional Taxonomies | 246W00000X Technician, Cardiology (Licence: 00118104) |
| 246XS1301X Spec/Tech, Cardiovascular, Sonography (Licence: 136434) | |
| Enumeration Date | 2023-04-19 |
| Last Update Date | 2025-05-19 |