| NPI | 1316198450 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 246ZE0600X Specialist/Technologist, Other, Electroneurodiagnostic (Licence: 1903) |
| Additional Taxonomies | 246Z00000X Specialist/Technologist, Other |
| 246ZE0600X Specialist/Technologist, Other, Electroneurodiagnostic | |
| Enumeration Date | 2008-10-07 |
| Last Update Date | 2018-04-10 |