| NPI | 1962716167 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2471S1302X Radiologic Technologist, Sonography |
| Additional Taxonomies | 246XC2903X Spec/Tech, Cardiovascular, Vascular Specialist (Licence: WY 24211) |
| Enumeration Date | 2010-07-29 |
| Last Update Date | 2010-07-30 |