| NPI | 1770512519 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 246XS1301X Specialist/Technologist Cardiovascular Sonography |
| Additional Taxonomies | 2471C3401X Radiologic Technologist Computed Tomography |
| 2471C3402X Radiologic Technologist Radiography | |
| 2471S1302X Radiologic Technologist Sonography | |
| Enumeration Date | 2006-07-02 |
| Last Update Date | 2007-07-08 |