NPI | 1417250846 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 246XS1301X Spec/Tech, Cardiovascular, Sonography (Licence: LA 81840) |
Additional Taxonomies | 2471V0105X Radiologic Technologist, Vascular Sonography (Licence: LA 00026985) |
Enumeration Date | 2010-12-07 |
Last Update Date | 2010-12-07 |