| NPI | 1720593098 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085U0001X Radiology, Diagnostic Ultrasound (Licence: CA 146834) |
| Additional Taxonomies | 246XS1301X Spec/Tech, Cardiovascular, Sonography |
| 246ZE0600X Specialist/Technologist, Other, Electroneurodiagnostic | |
| 2471S1302X Radiologic Technologist, Sonography | |
| 2471V0105X Radiologic Technologist, Vascular Sonography | |
| Enumeration Date | 2017-12-08 |
| Last Update Date | 2018-05-07 |