| NPI | 1679861553 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2471S1302X Radiologic Technologist, Sonography |
| Additional Taxonomies | 246XS1301X Spec/Tech, Cardiovascular, Sonography |
| 2471V0105X Radiologic Technologist, Vascular Sonography | |
| Enumeration Date | 2011-07-13 |
| Last Update Date | 2011-07-13 |