| NPI | 1619905502 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2471V0105X Radiologic Technologist, Vascular Sonography |
| Additional Taxonomies | 293D00000X Physiological Laboratory |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2009-05-05 |