| NPI | 1063967776 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIEN NGUYEN Manager 747-227-4647 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0600X |
| Additional Taxonomies | 246ZE0600X Specialist/Technologist, Other, Electroneurodiagnostic |
| Enumeration Date | 2016-08-23 |
| Last Update Date | 2022-07-21 |