| NPI | 1336697598 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 246ZE0600X Specialist/Technologist, Other, Electroneurodiagnostic (Licence: NY 2874) |
| Additional Taxonomies | 246ZE0500X Specialist/Technologist, Other, EEG |
| 2472E0500X | |
| Enumeration Date | 2016-09-16 |
| Last Update Date | 2016-09-16 |