| NPI | 1679695027 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 246XC2903X Specialist/Technologist Cardiovascular Vascular Specialist (Licence: FL 98570) |
| Additional Taxonomies | 246XS1301X Specialist/Technologist Cardiovascular Sonography (Licence: FL 98570) |
| 247200000X Technician, Other (Licence: FL 98570) | |
| Enumeration Date | 2007-04-05 |
| Last Update Date | 2007-07-08 |