| NPI | 1467873224 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 246ZE0600X Specialist/Technologist, Other, Electroneurodiagnostic (Licence: TX 829) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX 829) |
| Enumeration Date | 2013-12-21 |
| Last Update Date | 2013-12-21 |