| NPI | 1215463484 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2472E0500X Technician, Other, EEG |
| Additional Taxonomies | 246Z00000X Specialist/Technologist, Other |
| 246ZE0500X Specialist/Technologist, Other, EEG | |
| 247200000X Technician, Other | |
| Enumeration Date | 2017-05-10 |
| Last Update Date | 2017-05-10 |