NPI | 1912523036 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 246XC2903X Spec/Tech, Cardiovascular, Vascular Specialist |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2020-06-24 |
Last Update Date | 2025-06-09 |