| NPI | 1780871004 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2471S1302X Radiologic Technologist, Sonography (Licence: FL 54033) |
| Additional Taxonomies | 246XC2903X Spec/Tech, Cardiovascular, Vascular Specialist (Licence: FL 54033) |
| 246Z00000X Specialist/Technologist, Other (Licence: FL 494) | |
| 247100000X Radiologic Technologist (Licence: FL BMO52916) | |
| Enumeration Date | 2007-10-01 |
| Last Update Date | 2007-10-01 |