| NPI | 1770512519 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 246XS1301X Spec/Tech, 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 |