| NPI | 1154852077 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SELVON F. ST. CLAIR Manager 419-516-0315 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology |
| Additional Taxonomies | 204R00000X Electrodiagnostic Medicine |
| 2084N0400X Psychiatry & Neurology, Neurology | |
| 246ZE0600X Specialist/Technologist, Other, Electroneurodiagnostic | |
| Enumeration Date | 2017-03-22 |
| Last Update Date | 2017-03-22 |