| NPI | 1477176477 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QS1200X Clinic/Center, Sleep Disorder Diagnostic |
| Additional Taxonomies | 246ZE0500X Specialist/Technologist, Other, EEG |
| Enumeration Date | 2020-05-26 |
| Last Update Date | 2026-02-19 |