| NPI | 1639128333 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2471V0105X Radiologic Technologist, Vascular Sonography (Licence: FL 18214) |
| Additional Taxonomies | 2471S1302X Radiologic Technologist, Sonography (Licence: FL 18214) |
| Enumeration Date | 2006-05-09 |
| Last Update Date | 2017-11-17 |