| NPI | 1740744317 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2471V0105X Radiologic Technologist, Vascular Sonography (Licence: TX 103109) |
| Additional Taxonomies | 2085U0001X Radiology, Diagnostic Ultrasound (Licence: TX 103109) |
| Enumeration Date | 2019-01-28 |
| Last Update Date | 2019-01-28 |