NPI | 1104493485 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 261QS1200X Clinic/Center, Sleep Disorder Diagnostic |
Additional Taxonomies | 156F00000X Technician/Technologist (Licence: CA PTGL296) |
251E00000X Home Health | |
Enumeration Date | 2021-06-07 |
Last Update Date | 2021-08-25 |