| NPI | 1730358227 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2471V0105X Radiologic Technologist, Vascular Sonography (Licence: SC 79645) |
| Additional Taxonomies | 247100000X Radiologic Technologist (Licence: SC 199483) |
| Enumeration Date | 2008-02-28 |
| Last Update Date | 2008-02-28 |