| NPI | 1780653246 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 246XC2903X Spec/Tech, Cardiovascular, Vascular Specialist (Licence: PA 00013013) |
| Additional Taxonomies | 246XS1301X Spec/Tech, Cardiovascular, Sonography (Licence: PA 103620) |
| Enumeration Date | 2006-03-16 |
| Last Update Date | 2007-07-08 |