| NPI | 1730519315 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 246XS1301X Spec/Tech, Cardiovascular, Sonography (Licence: OH 117668) |
| Additional Taxonomies | 246XC2903X Spec/Tech, Cardiovascular, Vascular Specialist (Licence: OH 117668) |
| Enumeration Date | 2013-11-19 |
| Last Update Date | 2013-11-19 |