NPI | 1316502917 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 246ZE0500X Specialist/Technologist, Other EEG (Licence: TX 6485) |
Additional Taxonomies | 246ZE0600X Specialist/Technologist, Other Electroneurodiagnostic |
246ZS0410X Specialist/Technologist, Other Surgical Technologist | |
Enumeration Date | 2019-05-08 |
Last Update Date | 2019-05-08 |