| NPI | 1447794896 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 246ZE0600X Specialist/Technologist, Other Electroneurodiagnostic (Licence: 726) |
| Additional Taxonomies | 246ZE0500X Specialist/Technologist, Other EEG (Licence: 3271) |
| Enumeration Date | 2016-12-05 |
| Last Update Date | 2016-12-05 |