| NPI | 1871704478 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 247200000X Technician, Other |
| Additional Taxonomies | 246X00000X Spec/Tech, Cardiovascular (Licence: 26552) |
| 246XC2903X Spec/Tech, Cardiovascular, Vascular Specialist (Licence: 26552) | |
| 246XS1301X Spec/Tech, Cardiovascular, Sonography (Licence: 26552) | |
| 2471S1302X Radiologic Technologist, Sonography (Licence: 26552) | |
| 2471V0105X Radiologic Technologist, Vascular Sonography (Licence: 26552) | |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2025-09-11 |