| NPI | 1487041794 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2471S1302X Radiologic Technologist, Sonography (Licence: AZ 24651) |
| Additional Taxonomies | 246XS1301X Spec/Tech, Cardiovascular, Sonography (Licence: AZ 24651) |
| Enumeration Date | 2015-04-24 |
| Last Update Date | 2015-04-24 |