| NPI | 1891370300 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 246XS1301X Spec/Tech, Cardiovascular, Sonography (Licence: TX 00108285) | 
| Additional Taxonomies | 246XC2903X Spec/Tech, Cardiovascular, Vascular Specialist (Licence: TX 00108285) | 
| Enumeration Date | 2021-03-16 | 
| Last Update Date | 2021-03-16 |