| NPI | 1649333618 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 246Y00000X Spec/Tech, Health Info |
| Additional Taxonomies | 2471S1302X Radiologic Technologist, Sonography |
| 2471V0105X Radiologic Technologist, Vascular Sonography | |
| 246XS1301X Spec/Tech, Cardiovascular, Sonography | |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2007-07-08 |